By Joy Jensen, MN, RN 

Urinary Tract Infection (UTI) occurs when any part of the urinary tract become infected by bacteria.

• Kidneys: produce urine while filtering waste products from the blood

• Ureters: two tubes that carry urine from the kidneys to the bladder

• Bladder: a balloon-like structure that empties by pushing urine out through the urethra

• Urethra: opens in front of the vagina in females and at the tip of the penis in males

There are many types of UTIs. Urethritis is caused by an infection in the urethra. Cystitis is caused by an infection in the bladder. These lower urinary tract infections are more common and less serious. While Pyelonephritis, caused by an infection in the kidney, may occur if a lower tract UTI is untreated. These more serious infections may require hospitalization and intravenous antibiotics.

Urinary Tract Infections Causes

• The short female urethra opens close to the vagina and anus, both key sources of bacteria

• Sexual activity can move bacteria to the urethral opening, and move up into the bladder

• Not drinking enough fluids may result in impaired functioning of the urinary system and retention of toxins

• Purposely holding in urine for long periods of time, which reduces the “flushing out” process of urination

• Conditions that reduce the ability of the body’s immune system to fight off infection (diabetes, illness)

• Spermicides and unlubricated condoms may cause skin irritation that allows bacteria to invade

• Spinal cord injuries or other nerve damage that makes the bladder difficult to empty regularly and completely

• Conditions that block the flow of urine, such as a tumor, kidney stone, enlarged prostate

• Catheters (tubes placed in the urethra and bladder to drain urine)

• Pregnancy: hormones and changes in the position of the uterus

Not every woman with a UTI has symptoms, but most notice at least one or more of the following signs:

• Pain or stinging while urinating

• A frequent or strong urge to urinate, while often producing only a small amount of urine

• Milky, cloudy, dark, bloody, or foul-smelling urine

• Lower stomach or back pain

Except for pregnancy and certain high-risk conditions, bacteria in urine without symptoms may not need treatment

The “Fake” UTI

Some women have UTI-like symptoms when they do not actually have a UTI. This is due to various irritants that an individual may be sensitive to. Once the irritant is removed all symptoms go away. These may include:

• Perfumed tampons, maxi-pads, body soap, laundry detergent or dryer sheets

• Lace or rubber underwear

• Over-douching

Diagnosis & Treatment for UTIs

• A urinalysis can test your urine for the presence of bacteria and white blood cells

• A urine culture makes bacteria easier to identify by mixing urine with substances that promote bacterial growth

• A sensitivity test can then determine which antibiotic(s) will be most effective to treat the infection

Standard treatment for UTI’s is bacteria-fighting antibiotics. The choice of medication and length of treatment depend on a person’s allergies, medical history, and type of bacteria causing the infection. Antibiotic medication is most effective when patients take the full recommended amount. It is important not to stop taking antibiotics at the first sign of improvement, as the infection may remain in the body even after symptoms disappear and later become worse.

Several lifestyle habits can reduce the likelihood that a person will contract a UTI.

• Drink plenty of fluids every day, especially water, to help flush bacteria from your system.

• Do not hold in your urine for a long time.

• Urinate after sexual intercourse to flush bacteria that might have entered the urethra during sex.

• Use cotton underwear and loose-fitting clothes to circulate air and keep the area around the urethra dry. Nylon underwear and tight-fitting pants can trap moisture that promotes bacterial growth.

In addition, women should:

• Wipe with toilet tissue from front to back to prevent bacteria from entering the vagina or urethra.

• Avoid using feminine hygiene sprays and soaps in the vaginal area, and avoid douches.

• Talk to your health care providers about changing birth control methods if you get recurring UTIs while using spermicides, diaphragms, or unlubricated condoms.

• Perform Kegel exercises to strengthen the muscles that support the pelvic floor and tighten the urethra