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This topic is about urinary
tract infections in teens and adults. For information about infections in
babies and young children, see the topic
Urinary Tract Infections in Children.
urinary tract is the system that makes urine and
carries it out of your body. It includes your
bladder and kidneys and the tubes that connect them. When germs get into this
system, they can cause an infection.
Most urinary tract
bladder infections. A bladder infection usually is not
serious if it is treated right away. If you do not take care of a bladder
infection, it can spread to your kidneys. A
kidney infection is serious and can cause permanent
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.
reasons that are not well understood, some women get bladder infections again
You may have an infection
if you have any of these symptoms:
Call your doctor right away if you think you have an
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.
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
help prevent these infections.
Learning about urinary tract infections:
Living with infections that keep coming back:
Bacteria that enter the
urethra and travel up the
urinary tract are the usual cause of
urinary tract infections (UTIs). Bacteria that
normally live in the
large intestine and are present in feces (stool) are
the most common source of infection. Sexual intercourse may move bacteria
into the urinary tract, especially in women.
Catheters, which are small, flexible tubes inserted
into the bladder to allow urine to drain, are a common source of bacterial
infection in people who are in hospitals or who live in long-term care
Sometimes bacteria traveling through the blood or
lymph system cause kidney or bladder
Kidney stones, an
enlarged prostate in men, and structural problems in
the urinary tract can contribute to UTIs by limiting the body's ability to
eliminate urine completely.
Symptoms of a
urinary tract infection (UTI) may include:
Some people have bacteria in their urinary tract without
having any symptoms. This is called
asymptomatic bacteriuria. These types of infections
often affect pregnant women, older adults, and people who need a
catheter to urinate. Pregnant women are screened for
asymptomatic bacteriuria and treated with antibiotics, because it can cause
preterm labor and other problems if not treated.
Asymptomatic bacteriuria may lead to infections that cause symptoms, but in
many cases it does not. It usually goes away without treatment.
other conditions, such as vaginal infections or irritable bladder, cause
symptoms similar to those of a UTI. Your doctor may evaluate your health for
one or more of these if you have urinary symptoms, depending on your medical
history and how well you respond to treatment for a UTI.
Urinary tract infections (UTIs) typically occur when bacteria from the rectal area
enter through the
travel up the
urinary tract to the bladder or kidneys.
Typically, UTIs cause urinary symptoms, such as pain or burning during
urination. Some mild bladder infections may go away on their own within a
couple of days. Most UTIs clear up quickly with antibiotics and home treatment,
which includes drinking plenty of water and urinating frequently. The amount of
time required to cure the infection and the need for urine tests will vary with
the location (bladder or kidneys), frequency, and seriousness of the infection.
Kidney infections and UTIs that are
complicated by other factors require longer
Complications of UTIs are not common but do occur.
Serious complications can include permanent kidney damage and widespread
infection (sepsis), which can be life-threatening. The risk is
greater if the infection is not treated or if the infection does not respond to
Some people have many UTIs. They are often new infections (recurrent UTIs), but they can also be the same infection coming back (a relapse). A rapid relapse
usually means that treatment failed or there is another problem affecting the
urinary tract (not just the infection). But recurrent
UTIs in women usually aren't serious.
UTIs are most common in
young to middle-aged women. They occur more often in women than in men
Some women have an ongoing problem with UTIs. If a woman has more
than two bladder infections in 6 months or more than three infections in a
year, she is said to have recurrent UTIs. Recurrent UTIs usually get better
with extended antibiotic treatment. But infection may recur as soon as the
woman stops taking antibiotics. For this reason, doctors usually recommend preventive antibiotics.
Most urinary tract infections in men are caused by bacteria, not by another problem.
But UTIs in older men are more often related to
prostate problems. This can make them more difficult
to treat. Having an
enlarged prostate, which is common in older men, can
limit the body's ability to pass urine. Repeated UTIs may indicate
epididymitis, or another urinary tract problem.
more information, see:
Urinary tract infections (UTIs) are most common in young to middle-aged sexually
women. Things that increase a woman's risk of getting
Things that increase a man's
risk of UTIs include:
factors apply to both women and men. These include:
Call your doctor immediately if painful urination or other symptoms of a
urinary tract infection (UTI) occur with:
Call your doctor immediately if you are pregnant and have symptoms of a UTI (listed above).
Call a doctor if you:
Watchful waiting is a wait-and-see approach. If
you get better on your own, you won't need treatment. If you get worse, you and
your doctor will decide what to do next.
In adults, home
treatment for minor urinary tract infections (UTIs) often resolves the problem.
Home treatment includes drinking plenty of water and urinating often, emptying
the bladder each time.
Watchful waiting is not appropriate if you:
The following health professionals can treat urinary tract
To prepare for your appointment, see the topic Making the Most of Your Appointment.
If you have symptoms of a
urinary tract infection (UTI), your first evaluation
by a doctor will likely include:
Your doctor may order a
urine culture to confirm the diagnosis of a suspected
UTI. But if your symptoms, medical history, and urinalysis make the presence of
an uncomplicated urinary tract infection likely, your
doctor may have you begin treatment with antibiotics without waiting for the
results of a urine culture.
A doctor may order a urine
If you are pregnant, your doctor may order a urine
If the infection does
not respond to treatment with antibiotics or recurs rapidly, if the infection
complicated by other factors, or, in some cases, if
the kidneys are infected, your doctor may order other tests to:
If you get UTIs often, your doctor may write you a
standing prescription for antibiotics that you can fill without a doctor's
appointment. Then when you first have symptoms of a UTI, you can start taking
medicine right away. You may want to use a
home test for UTI to make sure you have an infection
before you start antibiotics.
Antibiotics can treat most
urinary tract infections (UTIs) successfully. The
goals of treatment for UTIs are to relieve symptoms, eliminate the infection
and prevent recurrence, and prevent unlikely but serious complications such as
kidney damage and
sepsis. In pregnant women, treatment protects the
woman and the fetus. The number of days your doctor will have you take
antibiotics depends on your infection and the type of antibiotic
uncomplicated bladder infections is usually a
antibiotics and home treatment. Home treatment
includes drinking a lot of water and fluids and urinating frequently, emptying
your bladder each time. More testing is not needed if your symptoms
Oral antibiotics usually can treat kidney infections
(pyelonephritis). But you may need a brief hospital
stay and a short course of
intravenous (IV) antibiotics if you are too ill or
nauseated to take medicine by mouth (oral medicine). Kidney infections tend to
make people more severely ill than bladder infections.
need more tests before and after treatment if you:
If you have a severe kidney infection, or if a bladder or
kidney infection is
complicated by other factors, you may need hospital
urinary tract infection (UTI) does not improve after
antibiotics, you will need further evaluation and
additional antibiotic treatment.
If the infection spreads and
affects your kidney function or causes widespread infection (sepsis), you will need hospital care. These
complications are not common. And they rarely occur in people who are otherwise
healthy. People are at higher risk if they have an
impaired immune system,
diabetes, untreated urinary tract obstruction, and/or
other conditions that affect the kidneys or bladder.
infection, rather than a relapse of the same infection, usually is the cause of
a UTI that keeps coming back (recurs).
You can take steps to prevent new or
urinary tract infections (UTIs).
Keep the tip of your penis clean, especially if
you are uncircumcised. The foreskin can trap bacteria, which can then get into
the urinary tract and cause infection.
You may be able to cure an early
urinary tract infection (UTI) if you act promptly when
you have the first symptoms of a UTI, such as pain and burning with urination.
Try these home treatment steps that may stop an infection from getting worse:
To relieve pain, take a hot bath or lay a heating pad over
your genital area. Never go to sleep with a heating pad in place.
If you are a
woman who has frequent uncomplicated UTIs, your doctor may write a standing
antibiotics to take if you notice symptoms of a UTI.
If you and your doctor agree to follow this approach and you start to have symptoms
that you are certain are caused by a UTI, follow your doctor's instructions for
taking the medicine and for watching your symptoms. Be sure to tell your doctor
if your symptoms do not improve or if you start having UTIs more often than in
Oral antibiotics can treat most bladder
infections and uncomplicated kidney infections successfully. In many cases, if
the symptoms and
urinalysis suggest a
urinary tract infection (UTI), you will start taking
antibiotics without waiting for the results of a
The number of days your
doctor will have you take antibiotics depends on your infection and the type of
sometimes advise that women with repeat infections use
preventive antibiotic therapy. This may include taking
a small dose of antibiotics daily or on alternate days, taking antibiotics
after sexual intercourse (since sex often triggers UTIs in women with recurrent
infections), or taking antibiotics only when you develop symptoms. Talk with
your doctor about which treatment strategy is right for you.
Medicines used to treat UTIs include:
Medicines used to prevent recurrent UTIs include:
Be sure to tell your doctor if you are or think you may
be pregnant. Some of these medicines are not safe to use if you are
These medicines are often
prescribed in a less costly
generic form rather than under a brand name. A
pharmacist might also decide to give you a generic instead of a brand name
medicine unless the prescription says "no generic."
Take all of
the antibiotics your doctor has prescribed. Most people begin to feel better
soon after they begin the medicine. But if you stop taking the medicine as soon
as you feel better, the infection may return. And not taking the full course of
antibiotics encourages the development of bacteria that are
resistant to antibiotics. This not only makes
antibiotics less effective but also makes bacterial infections harder to
Many forms of bacteria have become resistant to common
antibiotics designed to destroy them. These are called antibiotic-resistant
bacteria. Antibiotic resistance among bacteria that cause UTIs has increased
steadily in recent decades. You and your doctor may have to try different
antibiotics, and different combinations of antibiotics, to find the right
medicine that will kill the bacteria that is causing your UTI. Before starting
you on a new antibiotic, your doctor may get a urine sample from you. Results
from tests on this sample will help guide the decision on which antibiotic you
UrologyHealth.org is a website written by urologists
for patients. Visitors can find specific topics by using the "search"
The website provides information about adult and
pediatric urologic topics, including kidney, bladder, and prostate conditions.
You can find a urologist, sign up for a free quarterly newsletter, or click on
the Urology A–Z page to find materials about urologic problems.
The Get Smart Web site at the Centers for Disease Control and Prevention (CDC) provides information for both consumers and health professionals on the appropriate use of antibiotics. The website explains the dangers of inappropriate use of antibiotics and gives tips on actions people can take to feel better if they have an infection that cannot be helped by antibiotics. Some materials are available in English and in Spanish.
This website is sponsored by the Nemours Foundation. It
has a wide range of information about children's health—from allergies and
diseases to normal growth and development (birth to adolescence). This website
offers separate areas for kids, teens, and parents, each providing
age-appropriate information that the child or parent can understand. You can
sign up to get weekly emails about your area of interest.
The National Institute of Diabetes and Digestive and
Kidney Diseases (NIDDK) is part of the U.S. National Institutes of Health. It
conducts and supports research on many of the most serious diseases affecting
public health, particularly the diseases of internal medicine. NIDDK sponsors
the National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC).
It has information about diseases of the kidneys and urologic system for people
with these diseases and their families, health professionals, and the
The National Kidney and Urologic Diseases Information
Clearinghouse (NKUDIC) provides information about diseases of the
kidneys and urologic system to people with these problems and to
their families, to health professionals, and to the public. NKUDIC answers
inquiries; develops, reviews, and distributes publications; and works closely
with professional and patient groups and government agencies to
coordinate resources about kidney and urologic diseases.
NKUDIC, a federal agency, is a service of the National
Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). NIDDK is part
of the National Institutes of Health under the U.S. Department of Health and
The National Kidney Foundation works to prevent kidney
and urinary tract diseases and help people affected by these conditions. Its
website has a lot of information about adult and child conditions. The site
has interactive tools, donor information, recipes for kidney disease patients,
and message boards for many kidney topics. Free materials, such as brochures
and newsletters, are available.
Other Works Consulted
Lee BSB, et al. (2007). Methenamine hippurate for preventing urinary tract infections. Cochrane Database of Systematic Reviews (4).
Neumann I, et al. (2008). Pyelonephritis (acute) in non-pregnant women, search date February 2007. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
Perrotta C, et al. (2008). Oestrogens for preventing recurrent urinary tract infection in postmenopausal women. Cochrane Database of Systematic Reviews (2).
May 16, 2011
E. Gregory Thompson, MD - Internal Medicine & Avery L. Seifert, MD - Urology
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