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Urinary Tract Infections: Get the Facts

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Posted by Eric M. Ghiraldi, DO

Urinary tract infections (UTIs) — often called bladder infections — are common. In my practice as a urologist, I treat UTIs often.

UTIs develop when bacteria enter the urinary tract through the urethra, the tube that carries urine from the body. The bacteria spread to the bladder, where they multiply and cause an infection. The symptoms can be very uncomfortable, but they can also be subtle and easy to miss.

That’s a problem because it is important to get medical care for any suspected UTI. If left untreated, the infection can spread from the bladder to the kidneys and cause a kidney infection.

UTIs are easier to treat in the early stages, and prompt treatment can prevent them from getting worse. I tell my patients that it’s important to know the signs and symptoms of this type of infection and to seek help as soon as they experience them.

Because symptoms may not be obvious, it’s also important to know if you are at increased risk for this type of infection. That can help you recognize the subtle signs. Here’s what I share with my patients to help them recognize a possible UTI.

When to suspect a UTI

UTIs often cause symptoms related to urination, such as:

  • Pain or burning while urinating
  • A frequent urge to urinate with little or no urine coming out
  • Blood in the urine, especially in younger women
  • Foul-smelling urine
  • Milky or cloudy urine

Other symptoms may be more general. These include:

  • Chills
  • Lower abdominal pressure
  • Feeling tired, shaky or weak, especially in older women
  • Feeling confused or even becoming delirious, especially in older adults
  • Fever
  • Back pain

Sex, age, and other factors can increase your UTI risk

Anyone can get a UTI, but they are more common in women and in older adults.

Women get UTIs up to 30 times more often than men. They're also more likely to have recurrent UTIs, defined as experiencing two or more infections in six months, or three infections within a year.

The increased risk is caused by anatomy and hormones. The female urethra is shorter than the male urethra, so bacteria can reach the bladder more easily. The female urethral opening is also very close to the anus, making it easier to transfer bacteria to the urethra. Hormonal changes that occur during pregnancy and after menopause change the environment in the urinary tract, which can heighten UTI risk as well.

The chances of getting a UTI or having recurrent UTIs also increase with age, because the muscles controlling the bladder weaken over time. This can make it harder for the bladder to fully empty. When small amounts of urine remain in the bladder, infection-causing bacteria are more likely to multiply and thrive.

Your risk for a UTI also increases if you:

  • Have sex more than three times a week
  • Have new or multiple sexual partners
  • Use certain forms of birth control, such as spermicidal agents or diaphragms
  • Have a urinary tract blockage, such as a kidney stone or enlarged prostate
  • Have diabetes or another condition that suppresses your immune system
  • Have a chronic kidney condition
  • Have certain neurological conditions, such as multiple sclerosis
  • Use a catheter
  • Have recently undergone a urinary tract exam or urinary surgery

Treatment is fast and effective

When I see a patient with a possible UTI, I test a sample of the patient's urine to check for specific types of bacteria.

Once a UTI has been confirmed, I typically prescribe a short course of antibiotics. The medicine works quickly, and it only takes a day or two for a patient to start feeling better. I remind my patients that it is important to take the entire medication course exactly as prescribed, even after symptoms ease up. Otherwise, small amounts of bacteria may remain in the urinary tract.

Some patients with UTI symptoms delay seeing a doctor at first, thinking that the infection will clear up on its own. But waiting may have serious consequences: UTIs can cause permanent damage if they spread to the kidneys. In rare cases, an infection can even move into the bloodstream, where it can trigger sepsis, a life-threatening immune response.

Managing recurrent UTIs

A patient’s family or medical history may also raise their risk for recurrent UTIs. Abnormalities in the urinary tract make infections more likely. Conditions such as diabetes or multiple sclerosis also raise risk. Women are more likely to experience repeated infections if they had their first UTI before age 15 or if their mother, sister, or daughter has recurrent UTIs.

When I see patients who have recurring UTIs, I take a proactive approach: I may recommend that a patient take a low-dose antibiotic daily to keep UTIs from developing. Or I'll prescribe antibiotics that a patient can take after sex or as soon as they sense an infection coming on.

If you experience repeated UTIs, let your doctor know. They may be able to help identify possible causes, or they may suggest that you see a urologist for specialized care.

Preventing infections

When I see patients with UTIs, I encourage them to take the following steps to prevent future infections.

  • Urinate regularly to flush infection-causing bacteria out of the urinary tract more frequently.
  • Empty your bladder when the urge strikes and try not to wait for more than three or four hours.
  • Urinate before and after sex to flush out potentially harmful bacteria.
  • Drink plenty of water to help dilute your urine and increase the number of times you have to urinate.
  • Wipe from front to back after urinating or having a bowel movement to prevent bacteria from the anus from reaching the urinary tract.
  • Avoid the use of irritating feminine products like deodorant sprays, powders and douches. These can irritate the urethra and raise your UTI risk.
  • Consider switching birth control methods if you use spermicides or a diaphragm.
  • Try drinking cranberry juice. Cranberries contain compounds that may prevent bacteria from sticking to the walls of the urinary tract. Some research suggests that drinking half a cup to 3 cups daily might reduce the risk for recurrent UTIs.
  • Manage chronic disorders like diabetes, which increase your UTI risk. Work with your healthcare provider to make sure any underlying conditions are well controlled.

The bottom line? You should always take UTI symptoms seriously. Go to Temple ReadyCare if you think you have a UTI. If you need help managing recurrent UTIs, make an appointment with a Temple urologist.

Helpful Resources

Looking for more information?

Eric M. Ghiraldi, DO

Dr. Ghiraldi is a urologist at Fox Chase Cancer Center. One of his favorite things about Urology is that it is constantly changing with newer technologies to treat urological conditions. He is dedicated to making sure patients have the best treatment options available to them.

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