Ask Your Family Doctor

Developed by the College of Family Physicians of Canada

What causes urinary tract infections?

Most urinary tract infections are caused by bacteria. Any part of your urinary tract can become infected. The urinary tract includes the kidneys, ureters, bladder and urethra. The kidneys take waste out of the blood. The ureters carry the waste (urine) from the kidneys to the bladder. The bladder stores the urine. The urethra is the tiny tube that empties the bladder when you voidvoid (pee).

What do urinary tract infections feel like?

Urinary tract infections cause pain when you void. If you have an infection, you may have any of the signs listed.

Signs of a urinary tract infection

	A burning when you void void
	Feeling like you need to void more often
	Feeling the urge to void but not being able to
	Leaking
	Bloody urine

Some women may feel pressure in the lower stomach, have low back pain, feel sick to their stomach and tired, and run a low-grade fever. Signs of an infection in the kidneys include higher fevers, chills, shivers and feeling ill.

Why do women have urinary tract infections more often than men?

Women tend to have urinary tract infections more often than men do because the urethra is shorter in women than in men, so bacteria have a shorter distance to travel. The urethra is near the anus (back passage) in women. Bacteria from the anus and rectum can travel up the urethra and cause infections. Wiping from the back to the front after a bowel movement can bring bacteria from the anus to the urethra.

Having sex may also cause urinary tract infections in women because bacteria can be pushed into the urethra. Using a diaphragm can lead to infections because diaphragms push against the urethra and make it harder to fully empty the bladder. The urine that stays in the bladder is more likely to collect bacteria and cause infections. Pregnant women seem to get infections of the kidneys more often than other women. Pregnancy may make it easier for infections to happen because carrying a baby puts pressure on the ureters and because pregnancy causes changes in hormones.

How are urinary tract infections treated?

If your family doctor thinks you have a urinary tract infection, he or she will test a sample of your urine to find out if bacteria are in it. Your doctor will then prescribe an antibiotic for you if you have an infection. Usually, symptoms of the infection go away a day or two after you start taking the treatment. Drinking cranberry juice and extra fluids can also help. Your doctor may give you one big dose of medicine, or medicine to take for several days or more. Your doctor may also prescribe a medicine to numb your urinary tract and make you feel better while the antibiotic starts to work. The medicine colors your urine bright orange, so don't be alarmed by the color when you void.

If you have infections often, your doctor may give you a low dose of medicine for a few months or more to prevent the infections from coming back.
If having sex seems to cause your infections, your doctor may suggest that you take a single antibiotic pill after you have sex to prevent urinary tract infections. You should also get up to void soon after sex which may also help prevent infections.

How much of a concern are urinary tract infections?

Urinary tract infections can be painful. But today's medicines keep urinary tract infections from becoming a threat to your health.
If you have urinary tract infections often, you can take some steps to help prevent them. Here are some suggestions for preventing urinary tract infections. Your family doctor can help you decide what changes would be helpful for you to make.

Tips to prevent urinary tract infections

	Drink plenty of water to flush out bacteria. Drinking cranberry juice also helps prevent urinary tract infections.
	Don't hold your urine. Void when you feel like you need to.
	Wipe from front to back after bowel movements.
	Void after having sex to help wash away bacteria.
	Use enough lubrication during sex. Try using a small amount of lubricant (such as K-Y Jelly) before sex if you're a little dry.
	If you get urinary tract infections often, you may want to avoid using the diaphragm as a method of birth control. Ask your doctor about other birth control choices.
	Take your medicine the way your doctor advises.

What is interstitial cystitis?

Sometimes if you have lots of bladder symptoms but the urine culture is negative, you may have a condition called interstitial cystitis. This requires other treatments.

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Revised 2007 The College of Family Physicians of Canada

This information provides a general overview on this topic and may not apply to everyone. To find out if this information applies to you and to get more information on this subject, talk to your family doctor. This health education material has been favorably reviewed by the Patient Education Review Committee of the College of Family Physicians of Canada: Dr Cathy MacLean, Halifax, NS (Scientific Editor) Dr C. Richard Fischer, Pickering, ON Dr Patrice Laplante, Fleurimont, QC Dr Richard Moffatt, Red Deer, AB Dr David Nunn, Kentville, NS Dr Cornelius Woelk, Winkler, MB The College of Family Physicians of Canada, one of the nation's largest medical groups, is committed to promoting and maintaining high standards for family physicians - the doctors who provide ongoing, comprehensive care for people of all ages. This patient education information was developed by The College of Family Physicians of Canada in cooperation with the American Academy of Family Physicians.

Support for this program has been provided by an educational grant to the Research and Education Foundation by Scotiabank.