Urinary tract infections can cause pain and discomfort, but in most cases are easily treatable and pass within a few days.
Although universally prevalent, urinary tract infections (UTIs) are 50 times more common in women than in men. About 5% of women develop symptoms each year, while most women experience at least one form of UTI in their lifetime and 20% suffer repeat attacks. Women who are pregnant, sexually active or postmenopausal are most at risk.
UTIs can cause pain and discomfort, but usually pass in a couple of days and can be treated with the help of antibiotics. However, high rates of recurrence and increasing antimicrobial resistance among certain pathogens can lead to further health complications.
Here we answer some of the frequently asked questions about UTIs in women.
What are the causes of UTIs?
The majority of UTIs are caused by bacteria from the bowel – most commonly bugs like Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Enterococcus faecalis and Staphylococcus saprophyticus. Infection occurs when such bacteria enters the urinary tract from the stomach, usually via the tube through which urine passes from the bladder and out of the body, known as the urethra. In women, the urethra is shorter and therefore closer to the back passage, which accounts for the increased risk of UTIs among women compared to men.
Other factors which increase the risk of contracting UTIs include conditions such as kidney stones that block the urinary tract, the use of contraceptive diaphragms or condoms coated in spermicide, and the inability to empty the bladder fully. A weakened immune system or use of a urinary catheter can also make people more vulnerable to infection.
Are there different types of UTI?
UTIs range from mild but painful inflammation within the bladder, called cystitis, to infection of the urethra, which is known as urethritis. In some cases, bacteria can travel from the bladder to the kidney and cause severe infections. Pyelonephritis, for example, occurs when infection reaches the kidney tissue itself.
What are the symptoms?
For women experiencing cystitis or urethritis, the most common symptoms include:
- Needing to urinate more often than usual, and pain or discomfort when doing so
- Sudden urges to urinate
- Feeling unable to empty the bladder fully
- A general sense of feeling unwell, tired and prone to aches and pains
- Pain low in the tummy
- Urine that is unpleasant-smelling, cloudy or contains blood
If infection spreads to the kidneys or the tubes connecting the kidneys to the bladder, called the ureters, additional symptoms can occur. These include:
- High temperatures
- Pain in the sides and back
- Nausea and vomiting
- Confusion, chills and agitation
Such infections, which are sometimes referred to as lower UTIs, can be serious if left untreated and cause serious damage to the kidneys or spread further.
How are UTIs diagnosed and treated?
If you’re experiencing any of the symptoms listed above, you should see your GP. If you want avoid long waiting times for consultation and antibiotic prescription, a private GP service
The usual diagnostic procedure is to take a urine sample to establish whether a UTI is present. Test strips are dipped in the sample to check for the presence of blood, protein, white blood cells or nitrates, which are all indirect signs of infection. Samples are also sent to laboratories for further assessment.
In most cases, antibiotics are the usual course of recommended treatment. A three-day course of antibiotic capsules or tablets will usually resolve the problem, although you’ll most likely be asked to submit another urine sample one-to-two weeks after you’ve completed your medication. Drinking lots of water is critical, while taking over-the-counter painkillers can help with any aches or discomfort you’re experiencing.
Occasionally, when UTIs are linked to an underlying condition or problem, surgery can be necessary. For some women after the menopause, for example, a brief procedure to stretch the neck of the bladder can help to resolve poor bladder emptying.
What about UTI prevention?
Recurrent UTIs can cause repeat discomfort and distress and, if untreated, lead to further health complications. There are preventative measures that can be taken, although evidence as to their efficacy is a little inconclusive.
Some health experts recommend:
- Showering rather than taking a bath, and avoiding the use of bubble bath, soap or talc around the genital area
- Trying to empty the bladder fully, including as soon as possible after sexual intercourse
- Going to the toilet as soon as you need to
- Keeping well hydrated
- Avoiding spermicidal-lubricated forms of contraception
- Wearing cotton underwear and wearing trousers that are not too tight.
Do cranberries work?
The health benefits of cranberries are certainly well established. High in nutrients, vitamins and antioxidants, they are often referred to as ‘super food’. They are also thought to offer a mild preventative benefit for women with reoccurring UTIs. However, this should not be overstated. A recent study claimed to have found that cranberries could help combat antibiotic resistance in UTIs. Met with overzealous media enthusiasm , this research – commissioned by a cranberry juice manufacturer, no less – has been met with scepticism in the medical industry. It certainly does little to strengthen the evidence that cranberries significantly reduce women’s chance of contracting UTIs.
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