Overview
A urinary tract infection happens when bacteria get into the urinary system. Most often they reach the bladder, which is called cystitis. Sometimes the infection travels up to a kidney, which is more serious.
UTIs are common, particularly in women, because the urethra is shorter and its opening is closer to the back passage, so bacteria have a shorter journey to the bladder.
Symptoms
- Pain, burning or stinging when passing urine
- Needing to pass urine more often, and more urgently, including at night
- Urine that is cloudy, dark or strong smelling
- Blood in the urine
- Pain low in the tummy, or in the back
Young children may have a fever, be irritable, feed poorly, vomit or start wetting the bed again. In older or frail people, and in those with a catheter, the first sign is often new confusion, agitation or shivering rather than burning.
When to see a doctor
Otherwise, see a doctor if the usual symptoms do not start to settle, if they keep coming back, or if you are a man with urine symptoms, as the cause may need looking into.
Causes
Most UTIs are caused by bacteria that normally live in the bowel and reach the opening of the urethra, then travel up into the bladder and multiply.
Anything that makes it harder to empty the bladder fully, or that gives bacteria a way in, makes infection more likely. That includes kidney stones, an enlarged prostate, a urinary catheter and pregnancy.
Risk factors
- Being a woman
- Pregnancy
- Not emptying the bladder fully, or holding on for long periods
- Not drinking enough fluid
- Sex, particularly with the use of spermicide
- Kidney stones or an enlarged prostate
- A urinary catheter
- Diabetes or a weakened immune system
Complications
An infection that spreads from the bladder to a kidney causes fever, back or side pain and vomiting, and can be serious. A kidney infection that is not treated can lead to sepsis, a life threatening reaction to infection. In pregnancy an untreated infection can affect both mother and baby.
Prevention
- Drinking enough fluid through the day
- Passing urine when you need to rather than holding on, and soon after sex
- Wiping from front to back after using the toilet
- Wearing loose cotton underwear, and avoiding scented soaps around the genital area
Diagnosis
A doctor will ask about the symptoms and may test a urine sample with a dipstick. The sample can also be sent to the laboratory to find out which antibiotic will work, which is usual in pregnancy, in men, in children and when infections keep returning.
Repeated infections, or infections in men and children, may lead to an scan to look for a stone, a blockage or a problem with emptying the bladder.
Treatment
Most UTIs are treated with a short course of , and symptoms usually begin to settle within a day or two. Pain relief such as paracetamol and drinking enough fluid help in the meantime.
A kidney infection needs prompt treatment and sometimes admission to hospital for antibiotics through a drip. For infections that keep returning, a doctor may look for an underlying cause, suggest preventive measures or, in some cases, a longer low dose course of antibiotics.
Myths and facts
Things people often say about this. Open each one to see what is true.
Myth“Women get urine infections because they are not clean enough.”What is true?
Fact
The main reason is anatomy: the urethra is shorter in women, so bacteria from the back passage reach the bladder more easily. Simple habits such as wiping from front to back help, but an infection is not evidence that someone is unclean.
Myth“Cranberry juice will cure a urine infection.”What is true?
Fact
Cranberry products and D-mannose are sometimes used to try to reduce repeated infections, and the evidence for them is limited. They are not a treatment for an infection that has already started, and they do not replace antibiotics when those are needed.
Myth“It will clear up on its own if I just drink lots of water.”What is true?
Fact
Some mild bladder infections do settle, and fluids and pain relief such as paracetamol help. But an untreated infection can travel up to the kidney, and a kidney infection can become serious and lead to sepsis. Get advice if symptoms are not improving or you feel unwell.
Myth“I can stop the antibiotics as soon as the burning goes.”What is true?
Fact
Symptoms often ease within a day or two, before the infection is fully dealt with. The course is prescribed for a set number of days for that reason. Ask your doctor or pharmacist before stopping early or saving tablets for next time.
Questions to ask your doctor
Tick the ones you want answered and take them with you.
Common questions
Why do I keep getting urine infections?
Repeated infections can be linked to not emptying the bladder fully, to sex, to changes after menopause, or to a stone, an enlarged prostate or a catheter. A doctor can look for a cause, suggest preventive steps and, for some people, offer a longer low dose antibiotic.
Can a man get a urine infection?
Yes, although it is less common. In men a UTI is more likely to have an underlying cause, such as an enlarged prostate or a problem emptying the bladder, so it is usually investigated rather than simply treated.
Is a UTI dangerous in pregnancy?
It needs prompt attention. Infections are more common in pregnancy and are more likely to spread to the kidneys, which can affect both mother and baby. Urine is often checked routinely during antenatal visits for this reason.
My elderly father has become confused. Could it be a urine infection?
It can be. In older and frail people a UTI often shows up as new confusion, agitation, shivering or worsening incontinence rather than burning. Confusion has many other causes too, so it should be assessed by a doctor without delay.
