Urinary Tract Infection (UTI) - Symptoms and Treatment

What is Urinary Tract Infection (UTI)

A bacterial INFECTION of the BLADDER and URETHRA. The most common bacterial culprit is Escherichia coli, which is normally present in the gastrointestinal tract. Other BACTERIA may also cause UTI. Typically UTI, commonly called bladder infection, refers to infection that remains in the bladder and urethra. UTI may be acute (come on suddenly) or chronic (occur repeatedly over time). Untreated or undertreated UTI can spread into the KIDNEYS (NEPHRITIS), causing significant illness and the potential for permanent damage to the delicate tubules and glomeruli of the nephrons.

Symptoms of Urinary Tract Infection (UTI) and Diagnostic Path

Symptoms of acute Urinary Tract Infection tend to be more intense than symptoms of chronic UTI, though either can be highly uncomfortable. The general symptoms of UTI include

• DYSURIA (burning with URINATION)
• URINARY FREQUENCY and URINARY URGENCY
• HEMATURIA (bloody URINE)
• cloudy, foul-smelling urine
• aching or discomfort in the lower pelvis or lower back

Urinalysis shows the presence of bacteria in most UTIs, confirming the diagnosis. Urinalysis does not identify the kind of bacteria, however. The doctor may choose to obtain a urine sample via BLADDER CATHETERIZATION (to avoid contamination by bacteria normally on the SKIN’s surface) and culture it in the laboratory to determine the kind of bacteria present. A urine culture is especially helpful in chronic Urinary Tract Infection or when symptoms fail to respond to initial treatment. A urologist may recommend additional diagnostic procedures for chronic Urinary Tract Infection to determine the underlying reasons for the frequency or persistence of infection.

Urinary Tract Infection (UTI) Treatment Options and Outlook

ANTIBIOTIC MEDICATIONS are the standard treatment for UTI. The antibiotic and length of treatment depend on the bacteria causing the infection. Most UTIs in women respond to a 3-day course of the antibiotic TMP-SMX or an antibiotic in the fluoroquinolone family such as ciprofloxacin. Women who cannot take either of these antibiotics may instead take an antibiotic in the tetracycline family (tetracycline or doxycycline) or the cephalosporin family (such as cefaclor). Men take the same antibiotics though often require a longer course, typically 7 to 10 days. It is important to continue taking all prescribed doses of the antibiotic, even when symptoms improve, to make sure the antibiotic kills all the bacteria. The doctor may prescribe low-DOSE antibiotic medications for longterm preventive therapy (six months to a year) in women who have recurrent UTIs.

The medication phenazopyridine, a topical anesthetic that numbs the inner lining of the bladder and urethra, relieves discomfort during the first 36 to 48 hours of the Urinary Tract Infection until the antibiotic begins eliminating bacteria. Phenazopyridine colors the urine deep orange and stains clothing. Some people experience intense bladder spasms, for which the doctor may prescribe a short course of antispasmodic medications such as flavoxate or methenamine.

Urinary Tract Infection (UTI) Risk Factors and Preventive Measures

UTIs are common in girls and women though uncommon in boys and men because of differences in anatomy. The very short female urethra provides an easy route for bacteria to travel into the bladder. Health experts estimate that one in five women will have at least one Urinary Tract Infection during her lifetime. Measures to reduce the risk for UTI include

• drinking enough water (six to eight 8-ounce glasses daily)
• urinating when the bladder signals it is full
• wiping with toilet tissue from front to back
• urinating soon after SEXUAL INTERCOURSE
• prophylactic antibiotics when Urinary Tract Infection occurs three times in a year or more frequently

About 20 percent of women who have one Urinary Tract Infection have another; recurrent Urinary Tract Infection is rare in men. Though untreated or undertreated Urinary Tract Infection can cause serious and permanent damage to the urinary system, people who have appropriately treated UTIs typically recover completely and without residual complications.

See also CYSTITIS; GLOMERULUS; NEPHRON; SEXUALLY TRANSMITTED DISEASES (STDS); URETHRITIS.

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