Urinary tract infections, or UTIs, are among the most common infections, especially in women. More than half of women will have at least one in their lifetime, and many will have more than one. Most UTIs are easy to treat, but they need prompt attention to avoid spreading to the kidneys.
What is a UTI?
A UTI is an infection anywhere in the urinary system: the kidneys, ureters, bladder or urethra. Most UTIs affect the bladder (cystitis) and the urethra (urethritis). They are usually caused by bacteria from the bowel, most often E. coli, entering the urethra and traveling up to the bladder.
Women get UTIs more often than men because the urethra is shorter and closer to the anus, making it easier for bacteria to reach the bladder.
Symptoms
Bladder infection
- A strong, persistent urge to urinate
- Burning or pain when urinating
- Passing small amounts of urine often
- Cloudy, dark or strong-smelling urine
- Blood in the urine (pink, red or cola-colored)
- Pressure or pain in the lower abdomen or pelvis
Kidney infection (pyelonephritis)
A kidney infection is more serious. Seek medical care promptly if you have:
- Fever and chills
- Pain in the back or side, below the ribs
- Nausea or vomiting
Older adults
UTIs in older adults may cause confusion, falls or new incontinence instead of typical symptoms. However, bacteria in the urine without symptoms is common in older people and usually does not need antibiotics.
Risk factors
- Female anatomy
- Sexual activity, especially with a new partner
- Use of diaphragms or spermicides for birth control
- Menopause, because lower estrogen changes the urinary tract and vaginal tissue
- Urinary catheters
- Blockages such as kidney stones or an enlarged prostate
- Diabetes or a weakened immune system
- Holding urine for long periods or not emptying the bladder fully
How UTIs are diagnosed
Your clinician may diagnose an uncomplicated bladder infection based on symptoms. Tests can include:
- Urinalysis: checks for white blood cells, red blood cells and signs of bacteria.
- Urine culture: identifies the specific bacteria and which antibiotics will work. It is especially useful for recurrent, complicated or hard-to-treat infections.
- Imaging such as ultrasound or CT for repeated infections, kidney infections or suspected blockages.
Treatment
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Antibiotics
Antibiotics are the main treatment. Common choices for uncomplicated bladder infections in women include:
- Nitrofurantoin, usually for 5 days
- Trimethoprim-sulfamethoxazole, usually for 3 days, where local resistance is low
- Fosfomycin, a single dose
Kidney infections, infections in men, infections during pregnancy and complicated infections need different antibiotics and often longer courses. Always take antibiotics exactly as prescribed and finish the course, even if you feel better.
Symptom relief
- Drink plenty of water to help flush bacteria.
- A heating pad on the lower abdomen can ease discomfort.
- Phenazopyridine, available over the counter, can relieve burning for a day or two. It turns urine orange and does not treat the infection.
When to see a doctor urgently
- Fever, chills, back or side pain, or vomiting
- Symptoms during pregnancy
- Symptoms in a man or a child
- Symptoms that do not improve within two days of starting antibiotics
- Blood in the urine without other symptoms
Preventing UTIs
- Drink enough fluids so you urinate regularly.
- Do not hold urine for long periods.
- Urinate after sex to help flush bacteria.
- Wipe from front to back after using the toilet.
- Avoid irritating products such as scented douches, powders and sprays in the genital area.
- Consider changing birth control if you use spermicides or a diaphragm and get frequent UTIs.
For recurrent UTIs
Recurrent UTI usually means two or more infections in six months or three or more in a year. Options your clinician may discuss include:
- Vaginal estrogen for postmenopausal women, which can significantly reduce recurrences
- Low-dose preventive antibiotics, taken daily or after sex
- Methenamine hippurate, a non-antibiotic option
- Cranberry products, which may modestly reduce the risk of repeat UTIs in some women, though they do not treat an active infection
You can read more from the National Institute of Diabetes and Digestive and Kidney Diseases.
Frequently asked questions
Can a UTI go away on its own?
Some mild bladder infections clear without antibiotics, but there is a risk of spreading to the kidneys. It is best to speak with a clinician, especially if symptoms are severe or last more than a day or two.
Are UTIs sexually transmitted?
No. However, sexual activity can push bacteria toward the urethra. Some sexually transmitted infections can cause similar symptoms, so testing may be needed.
Can men get UTIs?
Yes, though they are less common. UTIs in men are considered complicated and need medical evaluation.
The bottom line
UTIs are common and usually easy to treat with the right antibiotic. Burning, urgency and frequent urination are classic signs. Fever or back pain may mean a kidney infection and needs prompt care. Simple habits and, for recurrent infections, targeted prevention can keep UTIs at bay.
This article is for general information and is not a substitute for advice from a qualified healthcare professional.