Many women have a urinary tract infection (UTI) at some point during their lives. Some women will have repeat infections and may have them often. Most UTIs are not serious. They are easy to treat with antibiotics and symptoms can be relieved quickly.

A Woman’s Urinary Tract

• The urinary tract is made up of the following parts:
• Two kidneys which produce urine
• Two tubes called ureters that take urine from the kidneys to the bladder
• The bladder where urine is stored
• The urethra which carries urine from the bladder out of the body

The urinary tract has a lower part and an upper part. The lower tract is made up of the urethra and the bladder. The upper urinary tract consists of the kidneys and ureters. Infections of the bladder or urethra rarely cause long-term problems but they can be annoying.

Types of Urinary Tract Infections

Most UTIs start in the lower urinary tract. Bacteria can enter through the urethra and spread upward to the bladder. This causes cystitis or a bladder infection. In some cases, urethritis, an infection of the urethra, occurs at the same time. Bacteria that have infected the bladder may travel up the ureters to the kidneys. This can cause pyelonephritis, a kidney infection. An infection in the upper tract may cause a more severe illness than infection in the lower tract.

Women are more likely than men to get UTI’s because the urethra is shorter in a woman than in a man. That means bacteria can reach the bladder more easily.

Causes

There are many reasons why a woman may get a UTI. The most common causes include bacteria from the rectum and vagina, sex, or abnormalities in the urinary tract.

Bacteria

Bacteria from the bowel live on the skin near the rectum or in the vagina. These bacteria can spread and enter the urinary tract through the urethra. If they move the urethra, they may cause infections in the bladder and sometimes in other parts of the urinary tract.

Sex

Women’s anatomy makes them prone to getting UTI’s after intercourse. The opening of the urethra is in front of the vagina. During sex, bacteria near the vagina can be massaged into the urethra by the penis, fingers or devices.

Urinary tract infections also tend to occur in women who change sexual partners or begin having sex more often. Using spermicides or a diaphragm also can cause more frequent UTIs.

Abnormalities in the Urinary Tract

Infections also can occur when urine backs up instead of flowing out of the bladder. When this occurs, the bladder does not empty completely. This may be caused by:

• Blockage (a stone) in the kidneys, bladder or ureters made of a hard mass of crystals that blocks the flow of urine through the urinary tract
• A narrowed tube (or kink) in the urinary tract
• Diverticula—small pockets that bulge out of the bladder wall or out of the urethra and hold urine
• Problems with your pelvic muscles or nerves

In another condition that occurs in children, one or both ureters are abnormally short. This causes urine to back up into the kidneys. As a child grows, the ureters become longer and the problem often disappears on its own.

Other Causes

Certain other factors increase your chance of getting a UTI. You are more likely to get an infection if you:

• Are pregnant
• Had UTIs as a child
• Are past menopause
• Have diabetes

If you are pregnant and think you may have a UTI, be sure to tell your doctor promptly. If untreated, it may cause problems for you and your baby.

Symptoms

Symptoms of UTI’s can come on quickly. One sign is a strong urge to urinate that cannot be delayed (urgency). As urine flows, a sharp pain or burning called dysuria is felt in the urethra. The urge to urinate then returns minutes later (frequency). Soreness may be felt in the lower abdomen, in the back, or in the sides.

Other symptoms may show up in the urine. It may:

• Have a strong odor
• Look cloudy
• Sometimes be tinged with blood

Blood in the urine may be caused by a UTI, but it also may be caused by other problems. Tell your doctor promptly if you see blood in your urine.

If bacteria enter the ureters and spreads to the kidneys, symptoms also may include:

• Backpain
• Chills
• Fever
• Nausea
• Vomiting

If you have any of these symptoms, tell your doctor right away. Kidney infections are serious. They need to be treated promptly.

Symptoms linked with a UTI such as painful voiding can be caused by other problems such as an infection of the vagina or vulva. Tests may be needed to confirm the diagnosis. Be sure to let your doctor know if you have any of these symptoms.

Diagnosis

The key to treating a UTI is a prompt diagnosis. Your doctor may first do a simple test called urinalysis to find out whether you have a UTI. For this test, you will be asked to provide a urine sample.

This sample will be studied in a lab under the microscope for the presence of white and red blood cells and bacteria. Normal urine should not have bacteria or blood cells in it. If either of these shows up in the urine, you may have a UTI.

The urine sample also may be grown in a culture (a substance that promotes the growth of bacteria) to see which bacteria are present. The sample also may be tested with different antibiotics to see which one destroys the bacteria best. This is called a sensitivity test.

When an infection does not clear up with treatment, you have had several UTI’s in a row or you have pain, fever and chills, your doctor may need to examine your urinary tract more closely for signs of a more serious problem. He or she may use one of these tests:

• Intravenous pyelogram (IVP)—A special dye is injected into the body. As it passes to the urinary tract, X-ray images of the bladder kidneys and ureters are taken.
• Ultrasound exam—Images of the urinary tract are shown on a monitor.
• Cystoscopy—A thin, lighted tube with a lens at the end is passed through the urethra to check for any abnormalities.
• Computed tomography (CT)—Small X-ray beam rotates around the body to transmit images of body tissues in cross sections into a computer.
• Cystourethrography—A dye is put into the bladder and X-ray images are taken as you void.

Treatment

Antibiotics are used to treat UTI’s.  The type, dose, and length of the antibiotic treatment depends on the type of bacteria causing the infection and on your medical history.

If you often get UTI’s through sexual activity, you may be given an antibiotic to take in dingle doses after you have sex. If you have had more than two infections in one year, you may be given a daily dose for a few months.

In most cases, treatment is quick and effective. Most symptoms go away in one to two days. Be sure to take all the medication even though your symptoms may go away before you finish your prescription. If you stop treatment early, the infection may still be present or it could come back after a short time. About a week after you finish treatment, a urine test maybe done to see if the infection is cured.

For more severe infections such as a kidney infection you may need to stay in the hospital. These infections take longer to treat, and you may need medication intravenously through an IV line.

Recurrent Infections

Urinary tract infections that come back a week or two after treatment are called recurrent infections. They can be frustrating, annoying and difficult to treat.

The cause of recurrent UTIs may be difficult to find. Often the cause of the current infection is different from the cause of the last infection. Sometimes the cause is unknown.

Prevention

There are many ways to prevent UTIs:

• After a bowel movement or urinating, wipe from front to back.
• Wash the skin around the rectum and the genital area.
• Avoid using douches, powder and deodorant sprays.
• Drink plenty of fluids including water to flush bacteria out of your urinary system.
• Empty your bladder as soon as you feel the urge or about every two to three hours.
• Try to empty your bladder before and after sex.
• Wear underwear with a cotton crotch.

Some of these tips work only some of the time or in only some women. It is likely you will find one that works for you.

Finally . . .

Urinary tract infections are common and can be painful. If you have symptoms of a UTI, see your doctor right away. With prompt, proper treatment, these infections can be treated with success.