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Urinary tract infections (UTIs)

How do the kidneys, bladder and urethra work? The kidneys make urine which is brought into the bladder through long tubes called ureters. The bladder stores the urine until it is full, when it empties the urine through a tube called the urethra.

What are UTIs?

Although the urinary system is designed to keep bacteria that cause infection out, the body’s defenses sometimes fail. UTIs typically occur when bacteria get into the bladder through the urethra. When that happens, bacteria can multiply and develop into an infection in the urinary tract. UTIs, also called “bladder infections” or “cystitis,” are different from vaginal infections. Symptoms can include painful urination, more frequent urination and/or a strong urge to urinate. If you see blood in your urine, call your health care provider right away.

Why do women get more infections than men?

UTIs are more common in women than men for several reasons, such as:

  • Female anatomy. The female urethra is close to the vagina and rectum which naturally contain bacteria. A woman also has a shorter urethra than a man, which shortens the distance bacteria must travel to reach the bladder.
  • Sexual activity. Sexually active women tend to have more UTIs than women who aren’t sexually active. Having a new sexual partner also increases the risk.
  • Some types of birth control. Women who use diaphragms for birth control or spermicides are at higher risk for UTIs.
  • Menopause. After menopause, low estrogen levels cause changes in the urinary tract and decrease the amount of “friendly” bacteria in the vagina. This makes you more susceptible to infection.

How are UTIs diagnosed?

If you have symptoms - painful urination, more frequent urination, and/or a strong urge to urinate – the doctor can test a sample of your urine for a UTI. You will need to give a “clean catch” urine sample by urinating into a sterile cup after cleaning the nearby skin area with cleansing towelettes. The sample will then be studied in a lab for bacteria and can also be tested to see which bacteria are growing and which antibiotics will help. It can take two to three days to get a final result. A patient who has symptoms of urgency, frequency, and a burning feeling when passing urine, and bacteria showing in the urine culture, is considered to have a UTI.

How are UTIs treated?

Antibiotics are used to treat UTIs. The type, dose, and length of the antibiotic treatment depend on the type of bacteria causing the infection and your medical history. Treatment is usually quick and most symptoms go away in one or two days. Be sure to take all the medication even if your symptoms go away before you finish the prescription.

Is it a UTI or something else?

UTI symptoms can overlap with other conditions such as common vaginal infections and sexually transmitted infections like chlamydia or gonorrhea. Most of the time, vaginal infections include a vaginal discharge, burning or itching.

What are recurrent infections?

It is not unusual for women to have more than one UTI. In fact, your chances of getting another UTI increase with each UTI. In general, about 20 percent of women who get a UTI will develop a second. Women with a history of two UTIs have about a 30-percent chance of getting a third UTI. About 80 percent of those who develop three UTIs will have recurrences. If you have more than three UTIs in a year, you have recurrent infections and should see a specialist. The specialist will want to examine you and may ask for more tests. The first step in treating recurrent infections is finding the cause.

Factors that can increase the risk of recurrent infection include:

  • Blockage (a stone) in the ureters, kidneys or bladder that stops the flow of urine through the urinary tract.
  • A stone in the kidney or bladder that bacteria live in.
  • A narrowed or kinked tube in the urinary tract.
  • Problems with the pelvic muscles or nerves.
  • Failure to empty your bladder completely.
  • Diabetes and other diseases that impair the body’s defense against bacteria.
  • Using a catheter to empty the bladder. This happens in people who are hospitalized, paralyzed or with neurological problems that make it hard to control their ability to urinate.
  • Urinary surgery that involves medical instruments.

However, many women with recurrent UTIs will not have any of these conditions.

How can UTIs be prevented?

To help prevent UTIs, you can:

  • Wipe from front to back after a bowel movement and after urinating.
  • Empty your bladder before and after sex.
  • Avoid using douches, powder and deodorant sprays.
  • Drink plenty of fluids to flush bacteria out of your urinary system.
  • Empty your bladder at least every three hours.
  • Take cranberry pills. This helps some women.
  • Use probiotics.
  • Use vaginal estrogen cream to increase the number of friendly bacteria and decrease the number of infection-causing bacteria if you are postmenopausal. This comes in a prescription.
  • Control your blood sugars if you are a diabetic.