Urinary Tract Infections (UTIs)

Urinary tract infections (UTIs) are responsible for more than seven million visits to physicians' offices per year. Approximately 41 percent of women and 11 percent of men will have at least one symptomatic urinary tract infection during their lifetime.

How The Urinary Tract Works

The urinary tract makes and stores urine, one of the waste products of your body. Urine is made in the kidneys and travels down the ureters to the bladder. The bladder serves as a storage container for urine, which is then emptied by urinating through the urethra, a tube that connects the bladder to the body surface.

The kidneys are paired organs located in the back that serve as a filtration system to filter the blood and remove waste products in the form of urine. Kidneys adjust the body's balance of various chemicals (sodium, potassium, calcium, phosphorous and others) and monitor the blood's acidity. Certain hormones are also produced in the kidneys. These hormones help regulate blood pressure, stimulate red blood cell production and promote strong bones. The ureters are two muscular tubes that transport the urine down to the bladder.

Normal urine is sterile and contains no bacteria. However, bacteria may get into the urine from the urethra and travel into the bladder. A bladder infection is known as cystitis and a kidney infection is known as pyelonephritis. Kidney infections are much less common — but often more serious — than bladder infections.

Symptoms Of A UTI

When you have a urinary tract infection (UTI), the lining of the bladder and urethra become red and irritated just as your throat does when you have a cold. The irritation can cause pain in your abdomen and pelvic area and may make you feel like emptying your bladder frequently. You may even try to urinate but only produce a few drops and/or feel some burning as your urine comes out. At times, you may lose control of your urine. You may also find that your urine smells unpleasant or is cloudy.

Kidney infections often cause fevers and back pain. These infections need to be treated promptly because a kidney infection can quickly spread into the bloodstream and cause a life-threatening condition.

UTIs are often categorized as simple (uncomplicated) or complicated. Simple UTIs are infections that occur in normal urinary tracts. Complicated UTIs occur in abnormal urinary tracts or when the bacteria causing the infection is resistant to many antibiotic medications.

Causes Of A UTI

Large numbers of bacteria live in the rectal area and also on your skin. These bacteria may get into the urine from the urethra and infect the bladder and kidneys. Women are more prone to UTIs because they have shorter urethras than men so bacteria have a shorter distance to travel to reach the bladder.

Just as some people are more prone to colds, some people are more prone to UTIs. Women who have gone through menopause have a change in the lining of the vagina and lose the protective effects of estrogen that decrease the likelihood of UTIs. Postmenopausal women with UTIs may benefit from hormone replacement. Some women are genetically predisposed to UTIs and have urinary tracts that allow bacteria to adhere to it more readily. Sexual intercourse may also increase the frequency of UTIs.

Women who use diaphragms have also been found to have an increased risk of urinary infections when compared to those using other forms of birth control. Using condoms with spermicidal foam is also known to be associated with an increase in UTIs in women.

You are more likely to get a UTI if your urinary tract has an abnormality or has recently been instrumented (for example, had a catheter in place). If you are unable to urinate normally because of some type of obstruction, you will also have a higher chance of a UTI.

Disorders such as diabetes also put people at higher risk for UTIs because of the body's decrease in immune function and thus a reduced ability to fight infections.

Anatomical abnormalities in the urinary tract may also lead to UTIs. These abnormalities are often found in children at an early age but can also be found in adults. There may be structural abnormalities, such as outpouchings called diverticula, that harbor bacteria in the bladder or urethra or even blockages, such as an enlarged bladder, that reduce the body's ability to completely remove all urine from the bladder.

Diagnosing A UTI

If you are concerned about a UTI, contact your doctor. Ways to diagnose a UTI are via urinalysis and/or urine culture. A sample of urine is examined under a microscope by looking for indications of infection — bacteria or white blood cells in the urine. Your physician may also take a urine culture if needed. If you ever see blood in your urine, you should contact your doctor right away. Blood in the urine may be caused by a UTI but it may also be from a different problem in the urinary tract.

Treatment Of A UTI

A simple UTI can be treated with a short course of oral antibiotics. A three-day course of antibiotics will usually treat most uncomplicated UTIs. However, some infections may need to be treated for several weeks. Depending on the type of antibiotic used, you may take a single dose of medication a day or up to four daily doses. A few doses of medication may relieve you of the pain or urge to urinate frequently but you should still complete the full course of medication prescribed for you even if all symptoms have been relieved. Unless UTIs are fully treated, they can return.

If the UTI is a complicated UTI, then a longer period of antibiotics is given often for several weeks. UTIs in men are typically treated as a complicated infection.