Urinary Tract Infection | Causes, Symptoms, and Treatment

What is a Urinary Tract Infection (UTI)?

A urinary tract infection (UTI) occurs when bacteria, often from the skin or rectum, enter the urinary tract through the urethra.

Urinary tract infections (UTIs) can affect any part of the urinary tract, which includes the kidneys (kidney infection), bladder (cystitis) and urethra (urethritis). However, bladder infections are the most common type.

Women are more likely to have a urinary tract infection compared to men as their urethra is shorter and closer to the rectum.

When confined to the bladder, an infection can be unpleasant and painful. However, if a UTI spreads to the kidneys, it may cause severe health complications.

Causes of Urinary Tract Infection (UTI)

E. coli and other bacteria, such as Enterococcus, Pseudomonas, Klebsiella, and Proteus, are the most common culprits behind UTIs. These bacteria, typically from the gastrointestinal tract, can travel up the urethra to the bladder, causing infection. Urinary stones, blocked urine flow, or anatomical abnormalities can also contribute to developing a UTI.

Risk Factors for Urinary Tract Infection (UTI)

Risk factors that can increase the risk of UTI include:

• Sexually active
• Had a bladder or kidney infection in the last 12 months
• Usage of spermicide for birth control
• Menopause
• Pregnancy
• Kidney stones 
• Ureteral reflux 
• Enlarged prostate
• Young children and older adults have a higher risk 
• Engaged in anal sex and not being circumcised
• Poor hygiene
• Weak immune system
• Diabetes
• Genetic predisposition

Symptoms of Urinary Tract Infection (UTI)

Urinary tract infections (UTIs) can affect various parts of the urinary system, and the symptoms can vary depending on whether the infection is in the lower or upper urinary tract. Recognising the symptoms early can help patients seek timely treatment to prevent further complications.

Lower UTIs (bladder and urethra)

Lower UTIs, which affect the bladder and urethra, are typically characterised by discomfort and frequent urination. Common symptoms of lower UTIs include:

• Increased frequency of urination
• Strong urge to urinate despite having an empty bladder
• Foul-smelling urine
• Burning sensation or painful urination
• Cloudy appearance of urine
• Blood in the urine
• Lethargy and tiredness
• Lower abdomen pain

Upper UTI (kidneys and ureters)

Upper UTIs affect the kidneys and ureters, which are more serious, often resulting in additional symptoms. If the infection reaches the kidneys, you may experience:

• Symptoms mentioned above
• Fever (38oC or above)
• Chills and rigor
• Nausea and vomiting
• Lower back pain or pain in the sides of your back
• Restlessness

Complications of Urinary Tract Infection (UTI)

If treated promptly, UTIs rarely lead to complications. However, if left untreated UTIs can result in severe complications, including:

• Recurrent infections
• Kidney damage
• Premature delivery or low birth weight infant if UTI occurs during pregnancy
• Sepsis – a life-threatening complication 
• Narrowed urethra in men due to repeated infections of the urethra

Diagnosis of Urinary Tract Infection (UTI)

Your doctor would be able to diagnose a UTI based on your symptoms. There is a high likelihood of UTI if a woman has typical symptoms of bladder infection but does not have vaginal discharge or irritation.

In other cases, the following diagnostic tests may be used:

• Urinalysis: To look for white blood cells in the urine, a common indicator of infection.
• Urine culture: To identify the type of bacteria causing infection and determine the suitable antibiotic for the treatment.
• Cystoscopy: A procedure to examine the urethra and bladder for abnormalities, infections, or blockages.
• Imaging Tests: Imaging tests such as X-rays, ultrasound, Computed Tomography (CT) scan, and Magnetic resonance imaging (MRI) are not usually needed unless suspected of severe kidney infection or blockage in the urinary tract.

In some individuals, antibiotics may not effectively treat the infection, or urine tests may not detect an infection despite the presence of UTI symptoms. This may indicate that you have a chronic UTI. People aged 60 and older with chronic UTIs have an elevated risk of bladder cancer.

Urinary tract infections (UTI) in Children

All children under five diagnosed with UTI must be thoroughly investigated. There is a high chance that children with UTI have an underlying anatomical abnormality with their urinary tract. Therefore, UTI in children requires precise diagnosis and appropriate treatment. Precise diagnosis and appropriate treatment are essential, and in some cases, corrective surgery may be necessary to address anatomical issues.

Treatment options for Urinary tract infections (UTI)

Doctors commonly treat UTIs with a course of antibiotics, tailored to the type of bacteria causing the infection. Patients are advised to undergo a full course of treatment to completely eliminate the infection and prevent it from recurring.

You may also be prescribed pain relief medications such as phenazopyridine to reduce the burning pain in some UTIs. 

Preventing Urinary Tract Infection (UTI)

Preventing urinary tract infections (UTIs) involves simple but effective habits:

• Wipe from front to back after using the toilet to prevent bacteria from entering the urinary tract.
• Maintain a clean and dry genital area to reduce the risk of bacterial growth.
• Stay hydrated by drinking sufficient fluids, especially water, so that you urinate regularly and help flush out bacteria.
• Urinate after sexual intercourse to help clear any bacteria that may have entered the urethra.
• Avoid products like vaginal douches, sprays in the genital area, which can irritate the urinary tract and increase UTI risk.
• Consider an alternative birth control method if frequently developing UTIs due to spermicides or diaphragm.
• Vaginal oestrogen for post-menopausal women.
• Speak to your doctor about cranberry products, which may help reduce UTI recurrence.
• For children or individuals with incontinence, promptly change diapers or incontinence pads to prevent bacterial buildup.

Book an appointment for UTI Diagnosis and Treatment at Gleneagles Hospital Penang

Are you concerned about the risk factors or symptoms of urinary tract infection? Get in touch with us to book an appointment with an Urologist at Gleneagles Hospital Penang today for an early and accurate diagnosis with an effective personalised treatment plan. We assure you the best possible care tailored to your specific needs.