Urinary tract infection, adults

Urinary tract infection (UTI) is the name given to an infection of any part of the urinary system.

What is the urinary system?

The urinary system is made up of the kidneys, the ureters (the tubes that carry urine from the kidneys to the bladder), the bladder, and the urethra (the tube that passes from the bladder through the penis, or vulva - which is located between the vaginal opening and the clitoris - through which we urinate).

When we digest food, waste products are left behind in our blood and are removed by either the liver or the kidneys. The most important part of the waste products removed by the kidneys is known as urea. Urea is mixed with water to produce urine. The urine is passed down from the kidneys, through the ureters and into the bladder. Once the bladder is full of urine, the urine is passed from the body, through the urethra, when we urinate.

What is UTI?

A UTI develops when part of the urinary system becomes infected, usually by bacteria. Bacteria can enter the urinary system through the urethra, or more rarely, though the bloodstream. Usually there is no obvious reason why the urinary system gets infected, although some women find that they get UTIs after sexual intercourse.

There are two types of UTI:

• Lower UTI: this is an infection of the lower part of the urinary tract that includes the bladder and the urethra. An infection of the bladder is called cystitis, while an infection of the urethra is known as urethritis.
• Upper UTI: this is an infection of the upper part of the urinary tract that includes the kidneys and the ureters. Upper UTIs are potentially more serious than lower UTIs because there is a possibility of kidney damage.

Who can get a UTI?

UTIs are more common in women than in men. Around 50% of women will need treatment for at least one UTI during their lifetime.

UTIs occur rarely in children. Around 11% of girls and 4% of boys will have a UTI before they reach the age of 16. However, if children do get a UTI, the effects can be serious, so prompt treatment is important. For further information about UTIs in children, see the Useful links.

Treating UTIs in pregnant women is also important. If left untreated, a UTI can cause low birth weight, or premature birth.

UTIs can be treated using antibiotics. If treated properly, UTIs normally cause no further complications and the infection soon passes. However, if left untreated, UTIs can cause serious complications, such as kidney damage and blood poisoning, which can be fatal.

It is impossible to avoid getting a UTI but you can take steps to decrease the risk of developing the condition.

The symptoms of a lower urinary tract infection can include:

• pain, or a burning sensation during urination (dysuria),
• needing to urinate frequently or urgently,
• feeling that you are unable to urinate fully,
• cloudy, bloody or bad-smelling urine,
• pain in your lower abdomen, and
• mild fever (a high temperature between 37-38°C or 98.6-101.0°F).

The symptoms of an upper urinary tract infection can include:

• any of the symptoms of a lower urinary tract infection,
• a high fever (a high temperature over 38°C or 101.0°F),
• nausea or vomiting,
• shaking or chills, and
• pain in your lower back or side which is usually only on one side.

Urinary tract infections (UTIs) are caused when bacteria enters, and then infects, the urinary tracts. Bacteria, typically Escherichia coli, living in your colon, are often the cause of UTIs. The bacteria enter through the opening of the urethra and then multiply in the bladder.

It is thought that the bacteria can be inadvertently spread from your anus to your urethra. This can happen if, when wiping your anus after going to toilet, the toilet paper comes into contact with your genitals.

The bacteria can then move upwards through the urinary tract, infecting your bladder (cystitis) and your kidneys (pyelonephritis).

The presence of bacteria in your urine does not necessarily mean you will develop a UTI. For example, many people, particularly elderly people, have bacteria in their urine without suffering any ill effects. This is called 'asymptomatic bacteriuria'.

If you have a urinary tract infection (UTI), your GP will ask you about your symptoms. If you are male or you have the symptoms of an upper UTI, your urine should be tested. This is because UTIs in men or conditions with similar symptoms are potentially more serious, so a precise diagnosis is important.

If you have the typical symptoms of cystitis, then further tests will probably not be needed to confirm the diagnosis.

If you only have a few symptoms associated with UTI, your urine will be tested to confirm the diagnosis and see which antibiotics would be most suitable to treat the infection.

There is no simple test to tell whether you have lower or upper UTI, but symptoms of a high fever and a pain in your side or back normally indicate a upper UTI.

Urinary tract infections (UTIs) can be treated using antibiotics. Lower UTIs can normally be successfully treated using a three day course of antibiotics. Upper UTIs can usually be successfully treated using a seven day course of antibiotics. It is important to finish the course of antibiotics, even if you are feeling better.

Carers

If you are looking after an adult who has had urinary tract infection because they have difficulty taking care of their own wellbeing, Carers Direct may be able to help you. On Carers Direct you can find out all about how to get help with caring for the person you look after, your legal and employment rights, and getting benefits on Carers Direct.

Women are more likely to develop urinary tract infections (UTIs) than men. This is because in women, the urethra is located closer to the anus than in men, making it easier for bacteria from their anus to reach their urethra. The female urethra is also much shorter than the male urethra (which runs through the penis), making it easier for bacteria to reach the bladder.

You are also more likely to develop a UTI if:

• You have a condition that obstructs or blocks your urinary tract, such as kidney stones.
• You have a condition that prevents you from emptying your bladder fully.
• You have a weakened immune system, for example, because you have diabetes, or you are undergoing chemotherapy.
• You are female and sexually active - this is because sexual intercourse can irritate the urethra, allowing bacteria to travel more easily through it and into your bladder.
• You are male and have an enlarged prostate gland.
• You have a urinary catheter (a tube that is inserted into your bladder to drain away urine).

There are a number of things that you can do to reduce the risk of getting a urinary tract infection (UTI). These are outlined below.

• Drinking cranberry juice, or taking cranberry extracts, may help to prevent cystitis. However, you should not drink cranberry juice or take cranberry extracts if you are taking warfarin (a medicine used to prevent blood clots).
• Go to the toilet as soon as you feel the need to urinate, rather than holding it in.
• Treat constipation promptly as it can increase your chances of developing a UTI. Recommended treatments include increasing the amount of fibre in your diet (20- 30g of fibre a day), using a mild laxative on a short-term basis and drinking plenty of fluids. You should see your GP if symptoms do not improve after 14 days, or in the case of children, seven days.
• Wipe from front to back after going to the toilet.
• Practice good hygiene by washing your genitals every day and before having sex.
• Empty your bladder after sex.