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.

Elderly individuals, both men and women, are more likely to harbor bacteria in their genitourinary system at any time. These bacteria may be associated with symptoms and thus require treatment with an antibiotic. The presence of bacteria in the urinary tract of older adults, without symptoms or associated consequences, is also a well recognized phenomenon which may not require antibiotics. This is usually referred to as asymptomatic bacteriuria. The overuse of antibiotics in the context of bacteriuria among the elderly is a concerning and controversial issue.

For reasons that are not well understood, some women get bladder infections again and again.

What are the 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, or if you have diabetes, kidney problems, or a weak immune system.

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.
• Try drinking cranberry juice or taking cranberry pills.
• Urinate often. Do not try to hold it.
• If you are a woman, urinate right after having sex.

Recurrent UTI's

Patients with recurrent UTI's may need further investigation. This may include ultrasound scans of the kidneys and bladder or intravenous urography (X-rays of the urological system following intravenous injection of iodinated contrast material). If there is no response to treatment, interstitial cystitis may be a possibility.

During cystitis, uropathogenic Escherichia coli (UPEC) subvert innate defenses by invading superficial umbrella cells and rapidly increasing in numbers to form intracellular bacterial communities (IBCs). By working together, bacteria in biofilms build themselves into structures that are more firmly anchored in infected cells and are more resistant to immune system assaults and antibiotic treatments. This is often the cause of chronic Urinary Tract Infections.