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HealthTalks
Facts and Myths About Women’s Urological Issues
Sawsan Alkass, M.D.
Glickman Urological Institute
Cleveland Clinic
Appointments: 216.444.5600
Urinary Tract Infections
The urinary tract makes and stores urine, one of
the body’s liquid waste products. The urinary
tract includes the following parts:
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Kidneys, which produce urine by removing waste and water from the blood
Ureters, the tubes that carry urine from the
kidneys to the bladder
Bladder, the sac-like container for storing
urine
Urethra, the tube that carries urine from
the bladder out of the body
What is a urinary tract infection?
Normal urine contains no bacteria (germs).
Sometimes, however, bacteria from outside the
body get into the urinary tract, and cause infection and inflammation. This is a urinary tract
infection, which can involve the urethra (a condition called urethritis), kidneys (a condition
called pyelonephritis) or bladder, (a condition called cystitis). Cystitis is the most common
type of urinary tract infection.
What are the symptoms of a urinary
tract infection?
A urinary tract infection causes the lining of
the urinary tract to become red and irritated,
producing the following symptoms:
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Pain in the flank (side of the body),
abdomen, or pelvic area
Pressure in the lower pelvis
Frequent need to urinate (frequency)
Painful urination (dysuria)
Urgent need to urinate (urgency)
Incontinence (urine leakage)
The need to urinate at night
Abnormal urine color (cloudy urine)
Blood in the urine
Strong or foul-smelling urine
Other symptoms that might be associated with
a urinary tract infection include:
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Pain during sex
Penis pain
Fatigue
Fever (temperature above 100oF)
Chills
Vomiting
Mental changes or confusion
What causes a urinary tract infection?
Urinary tract infections are caused by microorganisms—usually bacteria—that enter the
urethra and bladder, causing inflammation
and infection. The bacteria also might travel
up the ureters and infect the kidneys.
More than 90 percent of cystitis cases are
caused by E. coli, bacteria normally found in
the intestines. Other organisms—including
chlamydia and mycoplasma—also cause urinary tract infections. Infections by these organisms usually are limited to the urethra and
reproductive organs. Chlamydia and
mycoplasma infections might be sexually
transmitted, in which case both partners must
be treated.
How common are urinary tract infections?
Urinary tract infections are very common,
occurring in two out of every 100 people. One
percent to 2 percent of children develop urinary tract infections. Each year, 8 million to
10 million visits to doctors are for urinary tract
infections.
Who gets urinary tract infections?
Anyone can get a urinary tract infection, but
they are more common in women. This is
because the urethra in females is shorter and
closer to the anus, where E. coli bacteria are
common. Older adults also are at higher risk
for developing cystitis. This increased risk
might be due to incomplete emptying of the
bladder related to various medical conditions, including an enlarged prostate or a
narrowing of the urethra. If you get frequent
urinary tract infections, your doctor might do
tests to check for other health problems—
such as diabetes or an abnormal urinary system—that might be contributing to your
infections.
How are urinary tract infections diagnosed?
Your doctor will use the following tests to diagnose a urinary tract infection:
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Urinalysis to examine the urine for red
blood cells, white blood cells, and bacteria (The number of white and red blood
cells can indicate an infection.)
Urine culture to determine the type of
bacteria in the urine, which is important
for determining the appropriate treatment
If your infection does not respond to treatment
or if you get repeated infections, your doctor
might use the following tests to examine your
urinary tract for disease or injury:
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Intravenous pyelogram (IVP), a series of
X-rays of the bladder, kidneys, and
ureters after a special dye is injected (The
dye helps the structures to show up better
on the X-ray.)
Ultrasound, a test that uses sound waves
to form images of internal organs
Cystoscopy, a test that uses a special
instrument fitted with a lens and a light
source (cystoscope) to see inside the bladder from the urethra
How are urinary tract infections treated?
Antibiotics, medicines that kill the bacteria, are
used to treat urinary tract infections. Your doctor will choose a drug that best treats the bacteria causing your infection. Commonly used
antibiotics include:
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Nitrofurantoin
Sulfonamides (sulfa drugs)
Amoxicillin
Cephalosporins
Trimethoprim/sulfamethoxazole
Doxycycline
Quinolones
It is very important that you follow your doctor’s directions for taking the medicine. Do not
stop taking the antibiotic because your symptoms go away and you start feeling better. If the
infection is not treated completely, with the full
course of antibiotics, it can return.
What are the complications of a urinary tract infection?
A urinary tract infection that is not treated can
lead to recurrent infections and a more serious
infection of the kidneys.
Can urinary tract infections be prevented?
There are some steps you can take to reduce
your risk of developing a urinary tract infection:
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Good hygiene of the genital area—especially in women—might help reduce the
chances of introducing bacteria into the
urethra. After a bowel movement, the
genitals should be wiped from front to
back to reduce the chance of dragging E.
coli bacteria from the rectal area to the
urethra.
Urinating frequently, which flushes bacteria out of the bladder, might reduce the
risk of cystitis in those who are prone to
urinary tract infections. Drinking plenty
of fluids encourages frequent urination.
Avoid fluids that irritate the bladder, such
as alcohol, citrus juices, and drinks containing caffeine.
Urinating immediately after sex might
help flush out bacteria that might have
been introduced during intercourse.
Practicing safe sex (using a condom) can
reduce the risk of a sexually transmitted
infection.
What is the outlook for a person with
a urinary tract infection?
While urinary tract infections might be
uncomfortable, they generally respond well to
treatment.
When should I call my health care
provider?
Call your health care provider if you have
symptoms of a urinary tract infection. Also call
if you have been diagnosed with an infection
and your symptoms get worse or you develop
new symptoms, especially fever, back pain, and
vomiting.
Notes
This information is not intended to replace the medical
advice of your doctor or health care provider. Please
consult your health care provider for advice about a
specific medical condition.
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