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Understanding, Preventing and Treating UTIs

How to Recognize and Manage UTI Symptoms

If you've ever had a urinary tract infection (UTI), you know that the often painful burning sensation and constant need to urinate can disrupt your everyday life.

It is important to learn more about the ins and outs of UTIs so you can take proper steps to quickly recognize and manage the symptoms.

Northwestern Medicine Urologist Anthony J. Schaeffer, MD, answers frequently asked questions about UTIs.

What is a UTI?

A UTI is an infection of the parts of your body that carry urine from your kidneys out of your body. This includes:

  • Your kidneys
  • Your ureters, or the tubes that carry urine from your kidneys to your bladder
  • Your bladder

What causes UTIs?

UTIs are more common in females because they have shorter urethras than males. In females, a UTI typically occurs when pathogenic bacteria migrate from the rectum, across the vagina, and into the urethra and urinary bladder where it causes an infection.

  • "Lower tract" UTIs occur in the bladder.
  • "Upper tract" UTIs occur in the kidneys and ureters.

What are the risk factors for getting UTIs?

  • Having susceptible vaginal mucosa. Some people have vaginal mucosa (mucus) that is more receptive to bacteria, this makes them more likely to get UTIs.
    • About 20% of women* are genetically predisposed to have very receptive vaginal mucosa, so they will have frequent recurrent infections.
    • Roughly one in two women* will have at least one UTI in their lifetime.
  • Spermicides, gels that kill sperm used as contraceptives, also make the vaginal surface more receptive to bacteria, which can increase your risk of developing a UTI.
  • Being post-menopausal. People who are post-menopausal have a dry vaginal mucosa that bacteria can bind to easily, increasing their risk for UTIs. Often vaginal estrogen creams that restore the health of the vaginal mucosa can greatly reduce the chance of a UTI.
  • Having diseases that impact your immune system, like diabetes and autoimmune disorders, can make you more susceptible to UTIs.

Can sexual intercourse cause UTIs?

Yes. In women, sexual intercourse can facilitate migration of bacteria through the urethra. Rectal intercourse is a risk factor for men. It can be helpful to urinate after intercourse and stay hydrated.

How is a UTI Treated?

Most likely, you will need antibiotics as soon as possible to cure the infection and to prevent it from getting worse. Your physician may take a urinalysis to check for bacteria and white blood cells. When providing a urinalysis, follow the instructions exactly to avoid contaminating your urine sample.

Your physician may also take a urine culture, but the results may not be available for 48 hours.

As soon as you receive a prescription, complete the entire course of antibiotics and follow the instructions exactly as directed, even if you're feeling better, to prevent another infection.

What can I do to manage the symptoms?

  • Drink plenty of water to help flush out the bacteria causing the infection. Drinking water can also help ease the burning sensation when you urinate by diluting your urine.
  • Make frequent trips to the bathroom to flush your system (the extra fluids will help).
  • Consider using a different form of contraceptionDiaphragms and spermicidal agents can cause irritations and make it hard to empty your bladder, creating an ideal environment for bacteria to grow.
  • If you have diabetes, keep your blood sugar at optimal levels.

Why do UTIs recur?

With each infection, your chances of getting another UTI increases. One reason for recurring UTIs is not properly completing the course of prescribed antibiotics for the original infection. Even if your symptoms have improved, the antibiotic may not have killed all the bacteria yet. There could be some lingering bacteria that could become resistant to the medication, so don't stop taking the antibiotic mid-course.

The main reason for recurring UTIs in females is increased vaginal receptivity for bacteria, either because of genetic predisposition and/or use of spermicides, or vaginal mucosa aging and lack of estrogen in post-menopausal females.

Are there considerations for pregnant people?

If you are pregnant, get a urinalysis and urine culture in your first trimester to check for bacteria. If no bacteria are present, you don't need to get other urine tests during your pregnancy. However, if bacteria are identified in the urine, your obstetrician may recommend a course of antibiotics. Even if the bacteria aren't causing symptoms, they can lead to complications for you or your baby. After the first infection is treated, your obstetrician may recommend urinalysis and urine culture every three months for the duration of the pregnancy.

What about older people?

Older adults frequently have bacteria in their bladder that cause no symptoms or health risk. The bacteria are usually found by chance when the urine is checked for some other reason. These bacteria are typically never treated because they do not cause symptoms; antibiotics may promote symptomatic infections that are resistant to treatment.

Does drinking cranberry juice prevent UTIs?

There is clear scientific evidence that cranberry products do not prevent or treat UTIs. To more effectively prevent UTIs, stay hydrated and urinate often during the day. "Holding it in" can lead to more frequent UTIs.

Vitamin C is also helpful for prevention. It helps your urine be more acidic, which can keep bacteria from growing. High-fiber carbohydrates in your diet also provide good digestive health.

UTIs are common but adding a few healthy habits to your daily routine may help you to better manage — and possibly prevent — a UTI from interfering with your life.

*Scientists do not always collect information from participants about gender identity. To avoid misrepresenting the results of this research, we use the same terminology as the study authors.