Urinary Tract Infection
What are urinary tract infections?
Urinary tract infections or UTIs are infections in any part of the urinary tract. They are a common health problem that affects millions of people each year. Women are especially prone to UTIs.
A UTI may affect any part of the urinary tract causing:
- Urethritis. This is an infection of the urethra. This is the hollow tube that carries urine from the bladder to the outside of the body.
- Cystitis. This is a bladder infection caused by germs that have moved up from the urethra.
- Pyelonephritis. This kidney infection is most often caused by an infection that has spread up the urinary tract, or by a blockage in the urinary tract. A blockage causes urine to back up into the ureters and kidneys. The ureters are the hollow tubes that drain urine from the kidneys into the bladder.
- Abscess. A collection of pus along the course of the urinary tract.
What causes urinary tract infections?
Normal urine is sterile and contains fluids, salts, and waste products. It does not contain bacteria, viruses, or fungi. A UTI happens when germs, most often bacteria from the digestive tract, get into the opening of the urethra and start to multiply.
Most UTIs are caused by E. coli bacteria, which normally live in the colon.
What are the symptoms of a urinary tract infection?
These are the most common symptoms of a UTI:
- Frequent urination
- Pain or burning when passing urine
- Urine looks dark, cloudy, or reddish in color. (Blood may be present in the urine.)
- Urine smells bad
- Feeling pain even when not urinating
- Pain in the belly (abdomen) area below the bellybutton, or in the back or side, below the ribs
- Nausea or vomiting
- Have a strong urge to urinate, but only a small amount of urine is passed
- Women may feel an uncomfortable pressure above the pubic bone
- Older adults can have a change in their mental state, such as confusion or severe lethargy
The symptoms of a UTI may look like other conditions or health problems. Always see a healthcare provider for a diagnosis.
How are urinary tract infections diagnosed?
Your healthcare provider will review your health history and do a physical exam. Other tests may include:
- Urinalysis. Lab testing of urine is done to check for various cells and chemicals. These include red and white blood cells, germs (such as bacteria), or protein.
- Urine culture. This is a lab test to grow possible bacteria found in the urine. It can also determine which antibiotics are best for treatment.
- Urine DNA tests. This is a lab test to isolate the DNA of bacteria living in the urine and find out which antibiotics will kill the bacteria.
If UTIs become a repeated problem, other tests may be used to see if the urinary tract is normal. These tests may include:
- Cystoscopy. In this test, a thin, flexible tube and viewing device is put in through the urethra to examine the bladder and other parts of the urinary tract. Structural changes or blockages, such as tumors or stones, can be found.
- Kidney and bladder ultrasound. This imaging test uses high-frequency sound waves to make images of the bladder and the kidneys on a computer screen. The test is used to determine the size and shape of the bladder and the kidneys, and check for a mass, kidney stone, cysts, or other blockages or abnormalities.
- CT scan. This is an imaging test that uses X-rays and a computer to make detailed images of the body. A CT scan shows details of the bones, muscles, fat, and organs.
How are urinary tract infections treated?
Treatment for UTIs may include:
- Other medicines to ease pain
During treatment, you may also need to make lifestyle changes, such as:
- Drinking plenty of water to help wash bacteria out of the urinary tract
- Not having coffee, alcohol, or spicy foods
- Quitting smoking
Can urinary tract infections be prevented?
These steps may help reduce the chance of getting UTIs:
- Drink plenty of water every day.
- Urinate when you feel the need. Don't wait.
- Females, wipe from front to back to keep bacteria around the anus from going in the vagina or urethra.
- Take showers instead of tub baths.
- Clean the genital area before and after sex. Urinate shortly after sex.
- Women should not use feminine hygiene sprays or scented douches.
- Cotton underwear and loose-fitting clothes help keep the area around the urethra dry. Tight clothes and nylon underwear trap moisture. This can help bacteria grow.
- Repeated UTIs can be treated with small doses of regular antibiotics.
Talk with your healthcare provider if you have any questions or concerns about UTIs.
Key points about urinary tract infections
- Urinary tract infections (UTIs) are a common health problem that affects millions of people each year. These infections can affect any part of the urinary tract.
- Most UTIs are caused by E. coli bacteria, which normally live in the colon.
- The most common symptoms of UTIs include changes in urination, such as frequency, pain, or burning.
- Rather than these common symptoms, older adults with UTIs can show signs of confusion and fatigue.
- Lab tests may be done for diagnosis. Imaging tests may be needed to see if the urinary tract is normal.
- Antibiotics are used to treat UTIs. Other treatments may include pain relievers., Drink plenty of water to help wash bacteria out of the urinary tract.
Tips to help you get the most from a visit to your healthcare provider:
- Know the reason for your visit and what you want to happen.
- Before your visit, write down questions you want answered.
- Bring someone with you to help you ask questions and remember what your provider tells you.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new directions your provider gives you.
- Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
- Ask if your condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if you do not take the medicine or have the test or procedure.
- If you have a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your healthcare provider if you have questions.
Urinary Tract Infections in Women
Urinary Tract Infections in Women
Urinary tract infections (UTIs) are most often caused by bacteria. These bacteria enter the urinary tract. The bacteria may come from inside the body. Or they may travel from the skin outside the rectum or vagina into the urethra. Female anatomy makes it easy for bacteria from the bowel to enter a person’s urinary tract. This is the most common source of UTIs. This means women develop UTIs more often than men.
Pain in or around the urinary tract is a common UTI symptom. But the only way to know for sure if you have a UTI is for the healthcare provider to test your pee. The two tests that may be done are the urinalysis and urine culture. These tests tell your provider if you have a UTI and what type of bacteria is causing it.
Gender words are used here to talk about anatomy and health risk. Please use this information in a way that works best for you and your provider as you talk about your care.
Types of UTIs
Cystitis. A bladder infection (cystitis) is the most common UTI in women. You may have an urgent or frequent need to pee. You may also have pain, burning when you pee, and bloody urine.
Urethritis. This is an inflamed urethra. This is the tube that carries urine from the bladder to outside the body. You may have lower stomach or back pain. You may also have an urgent or frequent need to pee.
Pyelonephritis. This is a kidney infection. It can be serious and damage your kidneys if not treated. You may need to stay in the hospital in severe cases. You may have a fever and lower back pain.
Medicines to treat a UTI
Most UTIs are treated with antibiotics. These kill the bacteria. The length of time you need to take them depends on the type of infection. It may be as short as 3 days. You may need a low-dose antibiotic for several months if you have repeated UTIs. Take antibiotics exactly as directed. Don’t stop taking them until all of the medicine is gone, even if you feel better. The infection may not go away fully and return if you stop taking the antibiotic too soon. You may also develop a resistance to the antibiotic. This can make it much harder to treat.
Lifestyle changes to treat and prevent UTIs
The lifestyle changes below will help get rid of your UTI. They may also help prevent future UTIs.
Drink plenty of fluids. This includes water, juice, or other caffeine-free drinks. Fluids help flush bacteria out of your body.
Empty your bladder. Always empty your bladder when you feel the urge to pee. And always pee before going to sleep. Urine that stays in your bladder can lead to infection. Try to pee before and after sex as well.
Practice good personal hygiene. Wipe yourself from front to back after using the toilet. This helps keep bacteria from getting into the urethra.
Wear cotton underwear. Don't wear synthetic or tight-fitting underwear that can trap moisture. Change out of wet bathing suits and workout clothing quickly.
Take showers. Showers are better than baths for preventing UTIs.
Use condoms during sex. These help prevent UTIs caused by sexually transmitted bacteria. Also don't use spermicides during sex. These can increase the risk for UTIs. Choose other forms of birth control instead. A low dose of a preventive antibiotic may be used for women who tend to get UTIs after sex. Be sure to discuss this choice with your healthcare provider.
Follow up with your healthcare provider as directed. They may test to make sure the infection has cleared. If needed, more treatment may be started.
Urinary Tract Infections in Men
Urinary Tract Infections in Men
We understand gender is a spectrum. We may use gendered terms to talk about anatomy and health risk. Please use this information in a way that works best for you and your provider as you talk about your care.
Urinary tract infections (UTIs) are most often caused by bacteria that invade the urinary tract. The bacteria may come from outside the body. Or they may travel from the skin outside of the rectum into the urethra. Pain in or around the urinary tract is a common symptom for most UTIs. But the only way to know for sure if you have a UTI is to have a urinalysis and urine culture.
Types of UTIs
Cystitis. This is a bladder infection. It's often caused by a blockage from an enlarged prostate. You may have an urgent or frequent need to pee. You may have bloody urine. Treatment includes antibiotics and medicine to relax or shrink the prostate. Some people need surgery.
Urethritis. This is an infection of the urethra. You may have fluid from the urethra or a burning feeling when you pee. You may have pain in the urethra or penis. It's treated with antibiotics.
Prostatitis. This is an inflammation or infection of the prostate. You may have an urgent or frequent need to pee, a burning feeling when you pee, or a fever. Or you may have a sore prostate, or a vague feeling of pressure. Prostatitis is treated with a range of medicines. This depends on the cause.
Pyelonephritis. This is a kidney infection. If not treated, it can be serious and damage your kidneys. In severe cases you may need to stay in the hospital. You may have a fever and low back pain.
Medicines to treat a UTI
Most UTIs are treated with antibiotics. These kill the bacteria. The length of time you need to take them depends on the type of infection. Take antibiotics exactly as directed until all of the medicine is gone, even if you feel better. If you don't, the infection may not go away. It may become harder to treat. For some types of UTIs, you may be given other medicine to help treat your symptoms.
Self-care to treat and prevent UTIs
The lifestyle changes below will help get rid of your infection. They may help prevent future UTIs.
Drink plenty of fluids. This includes water, juice, or other caffeine-free drinks. This helps flush bacteria out of your system.
Empty your bladder when you feel the urge to pee and before going to sleep. Urine that stays in your bladder promotes infection.
Use condoms during sex. These help prevent UTIs caused by bacteria spread from sex.
Keep follow-up appointments with your healthcare provider. They may do tests to make sure the infection has cleared. If needed, more treatment can be started.
Most UTIs respond to medicine. Some people need a procedure or surgery. This may be done to treat an enlarged prostate. Or it can remove a kidney stone or other blockage. Surgery can be done to treat problems caused by scarring or long-term infections.
Catheter-Associated Urinary Tract Infections
Catheter-Linked Urinary Tract Infections
A catheter-linked urinary tract infection (CAUTI) is an infection of the urinary tract. It's caused by bacteria that get into the urinary tract when a urinary catheter is used. This is a tube that’s placed into the bladder to drain urine.
The urinary tract
This tract includes the kidneys, ureters, bladder, and urethra. The kidneys filter blood and make urine. The ureters carry urine from the kidneys to the bladder. The bladder stores urine. The urethra carries urine from the bladder to the outside of the body.
What is a urinary catheter?
A urinary catheter is a thin, flexible tube. It's placed in the bladder to drain urine. Urine flows through the tube into a collecting bag outside of the body. There are different types of urinary catheters. The most common type is an indwelling catheter. This is also known as a urethral catheter. This is because it’s placed into the bladder through the urethra. It's also called a Foley catheter.
Why is a urinary catheter needed?
A urinary catheter is needed for any of these:
You can't move around for a long time after surgery or injury.
You have a surgery that requires you to be under anesthesia for a long time.
You have a blockage in your urinary system.
Your healthcare provider needs to precisely measure the amount of urine you pass.
The function of your kidneys and bladder is being tested.
In most cases, the urinary catheter is short term. You'll need it only until the problem that needs it is taken care of.
How does a CAUTI develop?
Bacteria can get into the urinary tract as the catheter is put into the urethra. Bacteria can also get into the urinary tract while the catheter is in place. The common bacteria that cause a CAUTI are ones that live in the intestine. These bacteria don’t normally cause problems in the intestine. But when they get into the urinary tract, an infection can occur.
Why is a CAUTI of concern?
Left untreated, a CAUTI can lead to health problems. These problems may include infections of the bladder, prostate, and kidney. A CAUTI can keep you in the hospital longer. If the infection is not treated in time, you may have serious health problems.
What are the symptoms of a CAUTI?
Tell a healthcare provider or seek medical care right away if you or a loved one has any of these symptoms:
A burning feeling, pressure, or pain in your lower belly (abdomen)
Fever or chills
Urine in the collecting bag that is cloudy or bloody (pink or red)
Burning feeling in the urethra or genital area
Aching in your back (by the kidneys)
Nausea and vomiting
Confusion, sleepiness, or a change in behavior (mainly affects older people)
Sometimes you may not have any symptoms. But you may still have a CAUTI.
How is a CAUTI diagnosed?
Your healthcare provider will order tests if you have symptoms of a CAUTI. These include a urine test and blood tests.
How is a CAUTI treated?
Treatment may involve any of these:
Antibiotics. Your healthcare provider will likely prescribe antibiotics if you have symptoms. Be aware that if you don’t have symptoms, you may not be given antibiotics. This is to prevent an increase in bacteria that can’t be killed by certain antibiotics.
Removing the catheter. The catheter will be taken out when your healthcare provider decides it’s no longer needed. This often helps stop the infection.
Changing the catheter. If you still need a catheter, the old one will be taken out. A new one will be put in. This may help stop the infection.
How do hospital and long-term facility staff prevent CAUTIs?
To keep patients from getting a CAUTI, staff members take these steps:
Prescribe a catheter only when it’s needed. It's taken out as soon as it’s no longer needed.
- Wash their hands or use an alcohol-based hand cleanser before doing catheter care.
Use a clean (sterile) method when placing the catheter into the urinary tract. To do that, before putting the catheter in, the caregiver washes their hands with soap and water. Then they put on sterile gloves. A sterile catheter kit that has cleansers is used to cleanse the genital area.
Hang the bag lower than your bladder. This helps stop urine from flowing back into your bladder.
Check that the bag is emptied regularly.
- Do clean intermittent catheterization. This means a catheter is put in so you can urinate. It's then taken out right away. It may be done several times a day.
What you can do as a patient to prevent a CAUTI
You can help prevent a CAUTI by doing the following:
Every day, ask your healthcare provider how long you need to have the catheter. The longer you have a catheter, the higher your chance of getting a CAUTI.
Ask a caregiver to clean their hands and put on gloves before touching your catheter.
If you’ve been taught how to care for your catheter, wash your hands before and after each session.
Check that your bag is lower than your bladder. If it’s not, tell your caregiver.
Don’t disconnect the catheter and drain tube. Doing so lets germs get into the catheter.
Cleaning the genital and perineal areas is very important. It helps decrease bacteria around the catheter. Ask your healthcare provider what you should use and how often to clean these areas.
If you are discharged with an indwelling catheter
Before you leave the hospital, make sure you know how to care for your catheter at home.
Ask your healthcare provider how long you need the catheter. Also ask if you need to make a follow-up appointment to have the catheter taken out.
Always use a clean (sterile) method when caring for your catheter. Wash your hands before and after doing any catheter care.
Call your healthcare provider or seek medical care right away if you develop symptoms of a CAUTI (see above).