Urinary Tract Infection

Urinary tract infections (UTIs) are common infections that occur when bacteria, typically from the skin or rectum, infect the urinary tract via the urethra.

UTIs can affect any part of the urinary tract, which includes the kidneys (pyelonephritis), 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 UTI

Bacteria that cause UTIs do not usually live in the urinary tract as they live in the gastrointestinal tract. UTIs occur when these bacteria enter the genital area, travel up via the urethra and into the bladder. 

The most common causative bacteria are Escherichia coli (E. coli), Enterococcus, Pseudomonas, Klebsiella, and Proteus.

Other causes of UTI may be due to the presence of calculi of the urinary tract or blocked urine flow because of the underlying anatomical abnormality or dysfunctional emptying of the bladder.

Risk factors of UTI

Risk factors 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 UTI

1. Lower UTIs (bladder and urethra):
   • Increased frequency of urination
   • Strong urge to urinate despite having an empty bladder
   • Foul-smelling urine
   • Burning sensation or pain during urination
   • Cloudy appearance of urine
   • Blood in the urine
   • Lethargy and tiredness 
   • Lower abdomen pain 
2. Upper UTI (kidneys and ureters):
   • 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 UTI

If treated promptly, UTIs rarely lead to complications. Untreated infections may lead to:

• 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 UTI

Your doctor would be able to diagnose 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:

• Urinalysis: To look for white blood cells in the urine
• Urine culture: To identify the type of bacteria causing infection and determine the suitable antibiotic for the treatment
• Cystoscopy: To look inside the urethra and bladder 

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 do not work, or urine tests do 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.

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. Corrective surgery is sometimes needed.

Treatment options for UTI

Doctors commonly treat this condition with a course of antibiotics. Patients are advised to undergo a full course of treatment to completely eliminate the infection. 

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

Preventing UTI

• When you go to the toilet, wipe from front to back
• Maintain a clean and dry genital area
• Stay hydrated. Drink sufficient fluids, especially water, so that you urinate regularly  
• Urinate after sexual intercourse
• Avoid products like vaginal douches, sprays in the genital area
• Alternative birth control method if frequently develop UTI due to spermicides or diaphragm
• Vaginal oestrogen for post-menopausal women
• Speak to your doctor about cranberry products
• Promptly change diapers or incontinence pads if soiled

Book an appointment at Gleneagles Hospitals

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