Struggling with UTIs? Here’s how to diagnose, treat and manage urinary tract infections.
By Dr Dan Wood
Can’t stop peeing, it hurts when you go, or your urine smells funny? It sounds like you might have a urinary tract infection (UTI). While UTIs are incredibly common infections, they can be extremely uncomfortable and make you feel very unwell, and if left untreated they can develop into something more serious, so it’s important to speak to your GP if you have any symptoms.
We speak to Dan Wood, Consultant Urological Surgeon, London Urology Associates at The Princess Grace Hospital, about urinary tract infection symptoms, causes and treatments:
What is a urinary tract infection?
A UTI is an infection in any part of the urinary system, including kidneys, bladder and urethra. Most infections occur in the lower urinary tract; the bladder and the urethra.
The condition ranges from cystitis – a mild but distressing inflammation that is limited to the bladder, to severe infections of the kidney, such as pyelonephritis – when the infection has reached the kidney tissue itself.
How do UTIs differ for men and women?
UTIs are much more common in women than men. This is because the urethra is much shorter in women.
It is rare for men to get infections and if they do they need investigation. It is much more common for women to get infections and they would usually only need investigating if they have a severe/complex infection or if the infections are recurrent.
Common urinary tract infection symptoms
Symptoms differ, depending on whether the infection affects the lower (bladder and urethra) or upper (kidneys and ureters) parts of the urinary tract. Common UTI symptoms include:
- Generally feeling tired and unwell
- Cloudy or foul smelling urine
- Increased need to urinate
- Pain or burningsensation when urinating
- Blood in your urine
- Lower abdominal pain
Urine infections are more common in the elderly, due to poor bladder emptying, an enlarged prostate, or incontinence associated with stroke or dementia. In older men, generalised symptoms such as confusion and incontinence can also be present.
What causes urinary tract infections?
UTIs are usually caused by bacteria (often from poo) entering the urinary tract. As women have a shorter urethra than men, bacteria are more likely to reach the bladder or kidneys and cause an infection:
• UTIs in men
In men infections may happen if there is a problem with emptying the bladder completely or if there are stones in the urinary tract.
• UTIs in women
The same is true for women but it is more common for women to get infections spontaneously due to their shorter urethra. Sometimes certain triggers might be associated – such as sexual intercourse, but it is also important to make sure that women have a good fluid intake and empty their bladder regularly and avoid constipation.
Urinary tract infection treatment
Infection limited to your bladder can be uncomfortable, and symptoms can worsen considerably if a UTI spreads to your kidneys, so it’s important to speak to your GP if you have any symptoms.
Following a urine sample, your GP or healthcare provider will usually recommend the following treatment:
✔️ If UTI is proven (on urine culture) then antibiotics are the mainstay of treatment.
✔️ In men this is always true, in women there is some evidence that with cystitis the symptoms may get better with ensuring a good fluid intake and regular voiding (urination).
✔️ Sometimes over-the-counter remedies can also be helpful.
✔️ Men with a UTI should always see a doctor and be investigated. They will almost certainly need antibiotics.
✔️ In women with cystitis their symptoms may resolve without antibiotics (although this may take a day or so longer) if the symptoms are more than those of just cystitis then antibiotics are likely to be needed.
✔️ Drink plenty of water (1500-2000 mls per day) and go for a pee regularly (every 3-4 hours at least).
⚠️ Drinking cranberry juice has traditionally been recommended for treating cystitis, but large studies suggest it does not make a significant difference, so stick to water.
Pregnancy and UTI treatment
If you are pregnant and you have a urinary tract infection, is it safe to take antibiotics for a UTI? The short answer is yes but you need to make sure your doctor knows you are pregnant and how far through your pregnancy you are, as it can make a difference to the type of antibiotic that it is safe to give you.
Potential UTI complications
The most worrying and urgent UTI complication is sepsis – where the infection spreads to the blood making someone very ill.
Occasionally, infections can cause damage to kidneys if they are recurrent or severe.
Contact your doctor if you develop any of the signs and symptoms of a urinary tract infection. UTIs are rare in men, so all cases require investigation.
If UTIs keep occurring, identification and treatment of the underlying cause is essential.
Patients who have the same infection coming back can be managed successfully by attending to ‘bladder toilet’ (drinking 2 to 3 litres of fluid daily and always passing urine at bedtime and after sex).
Drinking 250 to 500ml of fluid daily and avoidance of bubble baths may also help. If these measures fail, six months of continuous therapy with low dose antibiotics may be required.