Topic Overview
Is this topic for you?
This topic is about urinary
tract infections in teens and adults. For information about infections in
babies and young children, see the topic
Urinary Tract Infections in Children.
What is a urinary tract infection?
Your
urinary tract is the system that makes urine and
carries it out of your body. It includes your
bladder and kidneys and the tubes that connect them. When germs get into this
system, they can cause an infection.
Most urinary tract
infections are
bladder infections. A bladder infection usually is not
serious if it is treated right away. If you do not take care of a bladder
infection, it can spread to your kidneys. A
kidney infection is serious and can cause permanent
damage.
What causes urinary tract infections?
Usually,
germs get into your system through your urethra, the tube that carries urine
from your bladder to the outside of your body. The germs that usually cause
these infections live in your large intestine and are found in your stool. If
these germs get inside your urethra, they can travel up into your bladder and
kidneys and cause an infection.
Women tend to get more bladder
infections than men. This is probably because women have shorter urethras, so
it is easier for the germs to move up to their bladders. Having sex can make it
easier for germs to get into your urethra.
You may be more likely
to get an infection if you do not drink enough fluids, you have diabetes, or
you are pregnant. The chance that you will get a bladder infection is higher if
you have any problem that blocks the flow of urine from your bladder. Examples
include having kidney stones or an enlarged prostate gland.
For
reasons that are not well understood, some women get bladder infections again
and again.
What are the symptoms?
You may have an infection
if you have any of these symptoms:
- You feel pain or burning when you
urinate.
- You feel like you have to urinate often, but not much
urine comes out when you do.
- Your belly feels tender or
heavy.
- Your urine is cloudy or smells bad.
- You have
pain on one side of your back under your ribs. This is where your kidneys
are.
- You have fever and chills.
- You have nausea and
vomiting.
Call your doctor right away if you think you have an
infection and:
- You have a fever, nausea and vomiting, or
pain in one side of your back under your ribs.
- You have diabetes,
kidney problems, or a weak immune system.
- You are older than 65.
- You are pregnant.
How are urinary tract infections diagnosed?
Your
doctor will ask for a sample of your urine. It is tested to see if it has germs
that cause bladder infections.
If you have infections often, you
may need extra testing to find out why.
How are they treated?
Antibiotics
prescribed by your doctor will usually cure a bladder infection. It may help to
drink lots of water and other fluids and to urinate often, emptying your
bladder each time.
If your doctor prescribes antibiotics, take
the pills exactly as you are told. Do not stop taking them just because you
feel better. You need to finish taking them all so that you do not get sick
again.
Can urinary tract infections be prevented?
You can
help prevent these infections.
- Drink lots of water every day.
- Urinate often. Do not try to hold it.
- If you are a
woman, urinate right after having sex.
- Postmenopausal women may want to ask their doctors about using vaginal estrogen to prevent recurrent
UTIs.
Frequently Asked Questions
Learning about urinary tract infections: | |
Being diagnosed: | |
Getting treatment: | |
Living with infections that keep coming back: | |
Cause
Bacteria that enter the
urethra and travel up the
urinary tract are the usual cause of
urinary tract infections (UTIs). Bacteria that
normally live in the
large intestine and are present in feces (stool) are
the most common source of infection. Sexual intercourse may move bacteria
into the urinary tract, especially in women.
Catheters, which are small, flexible tubes inserted
into the bladder to allow urine to drain, are a common source of bacterial
infection in people who are in hospitals or who live in long-term care
facilities.
Sometimes bacteria traveling through the blood or
lymph system cause kidney or bladder
infections.
Kidney stones, an
enlarged prostate in men, and structural problems in
the urinary tract can contribute to UTIs by limiting the body's ability to
eliminate urine completely.
Symptoms
Symptoms of a
urinary tract infection (UTI) may include:
- Pain or burning when you
urinate.
- An urge to urinate frequently but usually passing only
small amounts of urine.
- Dribbling (inability to control urine release).
- Pain
or a feeling of heaviness in your lower abdomen.
- Reddish or pinkish
urine.
- Foul-smelling urine.
- Cloudy urine.
- Pain in your back just below the rib cage, on one side of your
body (flank pain).
- Fever and
chills.
- Nausea and vomiting.
Some people have bacteria in their urinary tract without
having any symptoms. This is called
asymptomatic bacteriuria. These types of infections
often affect pregnant women, older adults, and people who need a
catheter to urinate. Pregnant women are screened for
asymptomatic bacteriuria and treated with antibiotics, because it can cause
preterm labor and other problems if not treated.
Asymptomatic bacteriuria may lead to infections that cause symptoms, but in
many cases it does not. It usually goes away without treatment.
Several
other conditions, such as vaginal infections or irritable bladder, cause
symptoms similar to those of a UTI. Your doctor may evaluate your health for
one or more of these if you have urinary symptoms, depending on your medical
history and how well you respond to treatment for a UTI.
What Happens
Urinary tract infections (UTIs) typically occur when bacteria from the rectal area
enter through the
urethra and
travel up the
urinary tract to the bladder or kidneys.
Typically, UTIs cause urinary symptoms, such as pain or burning during
urination. Some mild bladder infections may go away on their own within a
couple of days. Most UTIs clear up quickly with antibiotics and home treatment,
which includes drinking plenty of water and urinating frequently. The amount of
time required to cure the infection and the need for urine tests will vary with
the location (bladder or kidneys), frequency, and seriousness of the infection.
Kidney infections and UTIs that are
complicated by other factors require longer
treatment.
Complications of UTIs are not common but do occur.
Serious complications can include permanent kidney damage and widespread
infection (sepsis), which can be life-threatening. The risk is
greater if the infection is not treated or if the infection does not respond to
antibiotics.
Although it is possible to have a relapse of the same
infection, most recurrent UTIs are caused by new infections. About 20 to 30 out of 100 women have recurrent infections.1 A rapid relapse
usually means that treatment failed or there is another problem affecting the
urinary tract (not just the infection). But recurrent
UTIs in women usually aren't serious.
UTIs in men
Men sometimes have
uncomplicated urinary tract infections.
UTIs in older men are more often related to
prostate problems. This can make them more difficult
to treat. Having an
enlarged prostate, which is common in older men, can
limit the body's ability to pass urine. Repeated UTIs may indicate
prostatitis,
epididymitis, or another urinary tract problem. For
more information, see the topic
Benign Prostatic Hyperplasia,
Epididymitis, or
Prostatitis.
What Increases Your Risk
Risk factors in women
Urinary tract infections (UTIs) are most common in young to middle-aged sexually
active
women. Things that increase a woman's risk of getting
UTIs include:
- Sexual activity, which pushes bacteria into
the urethra. Sexual activity with the use of a diaphragm and spermicide raises
the risk.
- Pregnancy.
- Previous
UTIs.
- Use of feminine hygiene products that contain
deodorant.
- Lack of
estrogen, which allows bacteria that can cause UTIs to
grow more easily in the
vagina or
urethra. Women who have gone through
menopause are at increased risk for UTIs.
Risk factors in men
Things that increase a man's
risk of UTIs include:
Risk factors in both women and men
Certain risk
factors apply to both women and men. These include:
- Not drinking enough fluids. Drinking more
fluids causes increased urination, reducing bacteria in the urinary tract and
bladder.
- Having a
catheter in place. Bacteria can enter the catheter and start an infection. Most at risk are
older adults who are in hospitals or who live in long-term care facilities.
- Kidney stones and other obstructions in the urinary
tract. These may block the flow of urine, raising the risk of bacterial
infection.
- Diabetes. People with diabetes are at
greater risk for UTIs because their immune systems are weakened. Also,
long-term high blood sugar can damage the kidneys' filtering system (diabetic nephropathy).
- Structural problems
of the urinary tract. These may be present at birth or develop later in
life.
When To Call a Doctor
Call your doctor immediately if painful urination or other symptoms of a
urinary tract infection (UTI) occur with:
- Nausea and vomiting.
- Fever and
chills.
- Pain in the back just below the rib cage, on one side of
your body (flank pain).
Call your doctor immediately if you are pregnant and have symptoms of a UTI (listed above).
Call a doctor if you:
- Have had UTI symptoms previously and have those
symptoms again.
- Have minor symptoms of a UTI that do not clear up
in 1 to 2 days, such as pain or burning when you urinate, foul-smelling urine,
or the urge to urinate frequently while passing only small amounts of
urine.
- Notice blood or pus in your urine.
- Have symptoms
of a UTI and you have diabetes.
- Have been taking antibiotics for a UTI but your symptoms do not
improve or they come back (recur) after improving temporarily.
Watchful waiting
Watchful waiting is a wait-and-see approach. If
you get better on your own, you won't need treatment. If you get worse, you and
your doctor will decide what to do next.
In adults, home
treatment for minor urinary tract infections (UTIs) often resolves the problem.
Home treatment includes drinking plenty of water and urinating often, emptying
the bladder each time.
- Try home treatment for 1 to 2 days if your
symptoms are minor.
- If your symptoms last longer than 1 to 2 days
or are severe, seek medical help.
Watchful waiting is not appropriate if you:
Who to see
The following health professionals can treat urinary tract
infections (UTIs):
To prepare for your appointment, see the topic Making the Most of Your Appointment.
Exams and Tests
If you have symptoms of a
urinary tract infection (UTI), your first evaluation
by a doctor will likely include:
Your doctor may order a
urine culture to confirm the diagnosis of a suspected
UTI. But if your symptoms, medical history, and urinalysis make the presence of
an uncomplicated urinary tract infection likely, your
doctor may have you begin treatment with antibiotics without waiting for the
results of a urine culture.
A doctor may order a urine
culture:
- For women with unusual UTI symptoms, such as
symptoms that last longer than 7 days, or symptoms of a kidney infection (pyelonephritis).
- For men before and after
treatment for a UTI.
- For anyone older than 65 with UTI
symptoms.
- If you have diabetes, an
impaired immune system, or structural problems in your
urinary tract.
- If your UTI symptoms return after 3 days of
treatment. A urine culture can identify what type of bacteria is causing the
infection, so that the most effective antibiotic for that bacteria can be
used.
- After treatment for a UTI in people who have kidney
infections (pyelonephritis), to make sure the infection is
cured.
- To screen young girls for
asymptomatic bacteriuria.
If you are pregnant, your doctor may order a urine
culture:
- If you have UTI symptoms.
- After treatment for a
UTI.
- To screen for asymptomatic bacteriuria.
Tests used less frequently
If the infection does
not respond to treatment with antibiotics or recurs rapidly, if the infection
may be
complicated by other factors, or, in some cases, if
the kidneys are infected, your doctor may order other tests to:
- Look for the cause of recurrent or chronic
infections.
- Check for other kidney problems.
- Diagnose
structural problems of the urinary tract that might make you more likely to get
UTIs.
- Find out whether the infection is caused by unusual
bacteria.
- Find out whether you have an
impaired immune system.
If you get UTIs often, your doctor may write you a
standing prescription for antibiotics that you can fill without a doctor's
appointment. Then when you first have symptoms of a UTI, you can start taking
medicine right away. You may want to use a
home test for UTI to make sure you have an infection
before you start antibiotics.
Treatment Overview
Antibiotics can treat most
urinary tract infections (UTIs) successfully. The
goals of treatment for UTIs are to relieve symptoms, eliminate the infection
and prevent recurrence, and prevent unlikely but serious complications such as
kidney damage and
sepsis. In pregnant women, treatment protects the
woman and the fetus. The number of days your doctor will have you take
antibiotics depends on your infection and the type of antibiotic
medicine.
Initial treatment
Treatment for
uncomplicated bladder infections is usually a
combination of
antibiotics and home treatment. Home treatment
includes drinking a lot of water and fluids and urinating frequently, emptying
your bladder each time. More testing is not needed if your symptoms
improve.
Oral antibiotics usually can treat kidney infections
(pyelonephritis). But you may need a brief hospital
stay and a short course of
intravenous (IV) antibiotics if you are too ill or
nauseated to take medicine by mouth (oral medicine). Kidney infections tend to
make people more severely ill than bladder infections.
You may
need more tests before and after treatment if you:
If you have a severe kidney infection, or if a bladder or
kidney infection is
complicated by other factors, you may need hospital
care.
Treatment if the condition gets worse or recurs
If
your
urinary tract infection (UTI) does not improve after
treatment with
antibiotics, you will need further evaluation and
additional antibiotic treatment.
If the infection spreads and
affects your kidney function or causes widespread infection (sepsis), you will need hospital care. These
complications are not common. And they rarely occur in people who are otherwise
healthy. People are at higher risk if they have an
impaired immune system,
diabetes, untreated urinary tract obstruction, and/or
other conditions that affect the kidneys or bladder.
A new
infection, rather than a relapse of the same infection, usually is the cause of
a UTI that keeps coming back (recurs).
- Women with recurrent bladder infections may be treated with
preventive antibiotic therapy.
- Recurrent
UTIs in men are usually a sign of prostate infection (prostatitis).
Chronic prostatitis can be hard to treat. For more information, see the topic
Prostatitis. Follow-up checkups are usually needed for men who have UTIs and are always needed if the infection recurs.
Prevention
You can take steps to prevent new or
relapsing
urinary tract infections (UTIs).
Prevention tips for men and women
- Drink plenty of water and other liquids each
day. This helps ensure that you urinate frequently, which flushes bacteria from
your urinary tract.
- Urinate when you have the urge. Don't hold your
urine for a long time.
- Avoid constipation.
- Ask your doctor
about taking methenamine to prevent recurrent UTIs.
- Ask your doctor
about taking antibiotics to prevent recurrent UTIs.
Prevention tips for women
- Urinate immediately after sexual intercourse.
This is the best protection women have against UTIs, because it helps prevent
bacteria from moving into the urethra.
- Avoid using condoms
coated with spermicide or a diaphragm for birth control if your doctor believes
they are causing you to get UTIs.
- Change sanitary napkins
often.
- Avoid douches, feminine hygiene sprays, and other feminine
hygiene products with deodorant. These can change the normal balance of
organisms that help prevent infection.
- Wipe from front to back
after using the toilet to avoid spreading bacteria from your anus to your
urinary tract.
- Try cranberry products like pure cranberry juice, cranberry extract, or cranberry pills.
- If you get UTIs often, ask your doctor about taking
antibiotics right after sexual intercourse to prevent recurrent
UTIs.
- Post-menopausal women may want to ask their doctors about
using vaginal estrogen to prevent recurrent UTIs.
Prevention tip for men
- Keep the tip of your penis clean, especially if
you are uncircumcised. The foreskin can trap bacteria, which can then get into
the urinary tract and cause infection.
Home Treatment
You may be able to cure an early
urinary tract infection (UTI) if you act promptly when
you have the first symptoms of a UTI, such as pain and burning with urination.
Try these home treatment steps that may stop an infection from getting worse:
- Drink lots of water, especially during the
first 24 hours after your symptoms appear. This will help make the urine less
concentrated and wash out the infection-causing bacteria. This may alter some
of your body's normal defense mechanisms. But most doctors recommend drinking a
lot of fluids when you have a UTI. Some people also drink
cranberry juice.
- Urinating frequently and completely, to empty your bladder each
time.
To relieve pain, take a hot bath or lay a heating pad over
your genital area. Never go to sleep with a heating pad in place.
Self-treatment of recurrent UTIs
If you are a
woman who has frequent uncomplicated UTIs, your doctor may write a standing
prescription for
antibiotics to take if you notice symptoms of a UTI.
If you and your doctor agree to follow this approach and you start to have symptoms
that you are certain are caused by a UTI, follow your doctor's instructions for
taking the medicine and for watching your symptoms. Be sure to tell your doctor
if your symptoms do not improve or if you start having UTIs more often than in
the past.
Medications
Oral antibiotics can treat most bladder
infections and uncomplicated kidney infections successfully. In many cases, if
the symptoms and
urinalysis suggest a
urinary tract infection (UTI), you will start taking
antibiotics without waiting for the results of a
urine culture.
The number of days your
doctor will have you take antibiotics depends on your infection and the type of
antibiotic medicine.
Antibiotics for recurrent infections
Doctors
sometimes advise that women with repeat infections use
preventive antibiotic therapy. This may include taking
a small dose of antibiotics daily or on alternate days, taking antibiotics
after sexual intercourse (since sex often triggers UTIs in women with recurrent
infections), or taking antibiotics only when you develop symptoms. Talk with
your doctor about which treatment strategy is right for you.
Medication choices
Medicines used to treat UTIs include:
- Antibiotics to cure the infection. Antibiotics used
for UTIs include sulfonamides with trimethoprim (such as Bactrim).
- Phenazopyridine (such as Uristat) to
treat the pain and burning of a UTI. Uristat is an example of phenazopyridine
you can buy without a prescription.
- Other
nonprescription medicines for pain. These include
acetaminophen (such as Tylenol) and
nonsteroidal anti-inflammatory drugs (NSAIDs) such as
ibuprofen (for example, Advil) and naproxen (for example, Aleve).
Medicines used to prevent recurrent UTIs include:
Be sure to tell your doctor if you are or think you may
be pregnant. Some of these medicines are not safe to use if you are
pregnant.
What to think about
These medicines are often
prescribed in a less costly
generic form rather than under a brand name. A
pharmacist might also decide to give you a generic instead of a brand name
medicine unless the prescription says "no generic."
Take all of
the antibiotics your doctor has prescribed. Most people begin to feel better
soon after they begin the medicine. But if you stop taking the medicine as soon
as you feel better, the infection may return. And not taking the full course of
antibiotics encourages the development of bacteria that are
resistant to antibiotics. This not only makes
antibiotics less effective but also makes bacterial infections harder to
treat.
Many forms of bacteria have become resistant to common
antibiotics designed to destroy them. These are called antibiotic-resistant
bacteria. Antibiotic resistance among bacteria that cause UTIs has increased
steadily in recent decades. You and your doctor may have to try different
antibiotics, and different combinations of antibiotics, to find the right
medicine that will kill the bacteria that is causing your UTI. Before starting
you on a new antibiotic, your doctor may get a urine sample from you. Results
from tests on this sample will help guide the decision on which antibiotic you
take next.
Other Places To Get Help
Organizations
| KidsHealth for Parents, Children, and
Teens |
| 10140 Centurion Parkway North |
| Jacksonville, FL 32256 |
| Phone: | (904) 697-4100 |
| Fax: | (904) 697-4125 |
| Web Address: | www.kidshealth.org |
| |
This Web site is sponsored by the Nemours Foundation. It
has a wide range of information about children's health, from allergies and
diseases to normal growth and development (birth to adolescence). This Web site
offers separate areas for kids, teens, and parents, each providing
age-appropriate information that the child or parent can understand. You can
sign up to get weekly e-mails about your area of interest. |
|
| National Institute of Diabetes and Digestive and Kidney
Diseases (NIDDK) |
| Building 31, Room 9A06 |
| 31 Center Drive, MSC 2560 |
| Bethesda, MD 20892-2560 |
| Phone: | (301) 496-3583 |
| Web Address: | www.niddk.nih.gov |
| |
The National Institute of Diabetes and Digestive and
Kidney Diseases (NIDDK) is part of the U.S. National Institutes of Health. It
conducts and supports research on many of the most serious diseases affecting
public health, particularly the diseases of internal medicine. NIDDK sponsors
the National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC).
It has information about diseases of the kidneys and urologic system for people
with these diseases and their families, health professionals, and the
public. |
|
| National Kidney and Urologic Diseases Information
Clearinghouse |
| 3 Information Way |
| Bethesda, MD 20892-3580 |
| Phone: | 1-800-891-5390 |
| Fax: | (703) 738-4929 |
| TDD: | 1–866–569–1162 toll-free |
| Email: | nkudic@info.niddk.nih.gov |
| Web Address: | http://kidney.niddk.nih.gov |
| |
The National Kidney and Urologic Diseases Information
Clearinghouse (NKUDIC), a federal agency, is a service of the National
Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). NIDDK is part
of the National Institutes of Health under the U.S. Department of Health and
Human Services. The clearinghouse provides information about diseases of the
kidneys and urologic system to people with kidney and urologic disorders and to
their families, to health professionals, and to the public. NKUDIC answers
inquiries; develops, reviews, and distributes publications; and works closely
with professional and patient organizations and government agencies to
coordinate resources about kidney and urologic diseases. |
|
| National Kidney Foundation |
| 30 East 33rd Street |
| New York, NY 10016 |
| Phone: | 1-800-622-9010 |
| Phone: | (212) 889-2210 |
| Fax: | (212) 689-9261 |
| Web Address: | www.kidney.org |
| |
The National Kidney Foundation works to prevent kidney
and urinary tract diseases and help people affected by these conditions. Its
website has a lot of information about adult and child conditions. The site
has interactive tools, donor information, recipes for kidney disease patients,
and message boards for many kidney topics. Free materials, such as brochures
and newsletters, are available. |
|
| UrologyHealth.org, American Urological
Association |
| 1000 Corporate Boulevard |
| Linthicum, MD 21090 |
| Phone: | 1-866-RING AUA (1-866-746-4282) toll-free (U.S. only)
(410) 689-3700 |
| Fax: | (410) 689-3800 |
| Email: | auafoundation@auafoundation.org |
| Web Address: | www.urologyhealth.org |
| |
UrologyHealth.org is a Web site written by urologists
for patients. Visitors can find specific topics by using the "search"
option. The Web site provides information about adult and
pediatric urologic topics, including kidney, bladder, and prostate conditions.
You can find a urologist, sign up for a free quarterly newsletter, or click on
the Urology Resource Center to find materials about urologic problems. |
|
References
Citations
- Gupta K, Stamm WE (2008). Urinary tract infections. In
DC Dale, DD Federman, eds., ACP Medicine, section 7,
chap. 23. Hamilton, ON: BC Decker.
Other Works Consulted
- Lee BSB, et al. (2007). Methenamine hippurate for
preventing urinary tract infections. Cochrane Database of Systematic Reviews (4).
- Neumann I, et al. (2008). Pyelonephritis (acute) in
non-pregnant women, search date February 2007. Online version of
BMJ Clinical Evidence:
http://www.clinicalevidence.com.
- Perrotta C, et al. (2008). Oestrogens for preventing
recurrent urinary tract infection in postmenopausal women. Cochrane Database of Systematic Reviews (2).
Credits
| By | Healthwise Staff |
|---|
| Primary Medical Reviewer | E. Gregory Thompson, MD - Internal Medicine |
|---|
| Specialist Medical Reviewer | Avery L. Seifert, MD - Urology |
|---|
| Last Revised | May 16, 2011 |
|---|
Seton is proud to have four hospitals – the only hospitals in Central Texas - that have earned the Magnet designation, the highest award for nursing excellence given by the American Nurses Association.