Urinary Tract Infection in Women

What is a urinary tract infection?

A urinary tract infection (UTI) is a bacterial infection in the urinary tract. The urinary tract includes the:

• kidneys
• ureters
• bladder
• urethra.

Any or all of these parts of the urinary tract can become infected. An infection that is not treated can permanently hurt the bladder and kidneys. It can even spread to the blood and cause life-threatening infection.

How does it occur?

Urinary tract infection is caused by bacteria. These bacteria can cause:

• cystitis (bladder infection)
• pyelonephritis (kidney infection)
• urethritis (inflammation of the urethra, which is the tube that drains urine from the bladder).

Normally the urinary tract does not have any bacteria in it. Bacteria that cause UTI often spread from the rectum or vagina to the urethra and then to the bladder or kidneys. Urinary tract infection is more common in women because the urethra is short. This makes it easy for bacteria to move up to the bladder and kidneys. Sometimes bacteria spread from another part of the body through the bloodstream to the urinary tract.

Many things can lead to an infection:

• An obstruction in the urinary tract, such as a kidney stone, can keep urine from moving from the kidney to the bladder.
• You are more likely to have an infection if you have diabetes or another problem that weakens your immune system.
• Many women seem to have more infections after sex.
• As you get older, it can be harder to empty the bladder completely. If some urine stays in the bladder, the few bacteria that get into the bladder can start growing and start an infection.

Often the cause of UTI is not known.

Women are more likely to have an infection if they:

• Are newly sexually active or have a new sexual partner.
• Are past menopause.
• Are pregnant.
• Have a history of diabetes, sickle-cell anemia, stroke, kidney stones, or any illness that causes the bladder to be paralyzed or unable to empty completely.

What are the symptoms?

The symptoms of UTI may include:

• urinating more often
• feeling an urgent need to urinate
• pain or discomfort (burning) when you urinate
• strong-smelling urine
• pain in the lower pelvis, stomach, lower back, or side
• urine that looks cloudy or reddish
• shaking chills
• fever
• sweats
• nausea and vomiting
• leaking of urine (incontinence)
• change in amount of urine, either more or less
• pain during sex.

How is it diagnosed?

Your healthcare provider will review your symptoms and examine you. The exam may include a pelvic exam. Your provider will check for tenderness of the bladder or kidney. A sample of your urine may be tested for bacteria and pus.

If you keep having infections or symptoms after treatment, your provider may suggest these tests:

• An intravenous pyelogram (IVP). An IVP is a special type of X-ray of the kidneys, ureters, and bladder.
• An ultrasound scan to look at the urinary tract.
• A cystoscopy. This is an exam of the inside of the bladder with a small lighted instrument. It is usually done by a specialist called a urologist.

How is it treated?

UTIs are treated with antibiotics. For uncomplicated urinary tract infections you may take a single dose of an antibiotic or you may take an antibiotic for 3 to 10 days. For chronic infections or infections that keep coming back, you may need to take antibiotics for a longer time. Take all the medicine your healthcare provider prescribes, even after the symptoms go away. If you stop taking your medicine before the scheduled end of treatment, the infection may come back.

Your provider can prescribe a medicine called Pyridium to relieve painful urination while the antibiotics are treating the infection. (This medicine turns your urine a dark orange color.)

If the infection is not treated, your kidneys may be damaged or the infection may spread to your blood. If the infection spreads to the blood, it can be fatal. If you have a severe kidney infection, you will be given IV antibiotics through your veins. You may have to stay in the hospital for a few days.

How long will the effects last?

Usually the symptoms of the infection stop in 2 to 3 days.

How can I take care of myself?

• Follow your healthcare provider's treatment.
• Drink more fluids, especially water, to help flush the bacteria from your system.
• If you have a fever:
  • Rest if you have a fever above 100 degrees F (38 degrees C). After your temperature falls below 100 degrees F (38 degrees C), you may be more active.
  • Take aspirin or acetaminophen to control the fever.
  • Keep a daily record of your temperature.
• A hot water bottle or an electric heating pad on a low setting can help relieve cramps or lower abdominal or back pain.
• Soaking in a tub for 20 to 30 minutes may help relieve any back or abdominal pain.
• If your symptoms continue for 2 or more days, or if you start having new symptoms, call your healthcare provider.

How can I help prevent a urinary tract infection?

You can help prevent UTIs if you:

• Drink plenty of water and other beverages.
• Do not wait to go to the bathroom when you feel the need to urinate.
• Use good hygiene when you use the toilet. For example, wipe from front to back to keep rectal bacteria from getting into the vagina and urethra.
• Avoid using irritating cosmetics or chemicals in the area of the vagina and urethra (such as strong soaps, feminine hygiene sprays or douches, or scented napkins or panty liners).
• Urinate soon after sex.
• Keep your genital area clean.
• Empty your bladder completely when you urinate.
• Wear all-cotton or cotton-crotch underwear and pantyhose. Change underwear and pantyhose every day.