Urinary Tract Infections - A common problem for some women

2010 rev.
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.

What causes urinary tract infections?

Most urinary tract infections (UTIs) are caused by bacteria. 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, which stores the urine. The urethra is the tiny tube that empties the bladder when you void (pee). Any part of your urinary tract can become infected, but bladder and urethra infections are most common.

UTI - English 

How do I know if I have a urinary tract infection?

Possible signs of a urinary tract infection are listed below. Nausea, lower back pain, fever, chills, and feeling ill may be signs of a more serious kidney infection. Call your doctor if you have any of these symptoms.

Possible signs of a urinary tract infection

  • A burning sensation when you void
  • Feeling like you need to void more often than usual
  • Feeling the urge to void but not being able to
  • Leaking
  • Cloudy, dark, smelly, or bloody urine
  • Feeling pressure in the lower abdomen

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

Women tend to get urinary tract infections more often than men because bacteria can reach the bladder more easily in women. Due to a shorter urethra in women than in men, bacteria have a shorter distance to travel.

The urethra is also located near the anus or rectum in women. Bacteria from the anus and rectum can easily 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 some 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 completely 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.

Other risk factors for urinary tract infections in women

Some women may have abnormalities of their urinary tracts from birth that may cause them to have frequent urinary tract infections. Medical conditions such as diabetes, cancer, HIV or other conditions that reduce one’s immunity may lead to frequent urinary tract infections.

Conditions that cause a blockage in the urinary tract such as kidney stones can also lead to frequent urinary tract infections. UTIs are also common in women (usually elderly), who need a urinary catheter for prolonged periods of time.

Urinary Tract Infections in pregnancy

When UTI occurs in pregnancy, the infection is more likely to travel to the kidneys due to hormonal changes and shifts in the position of the urinary tract. Your family doctor may recommend periodic testing of urine during pregnancy.

You should be treated promptly to avoid premature delivery of your baby and other complications such as high blood pressure. Remind your doctor that you are pregnant so that he/she will prescribe an antibiotic that is safe for the baby.

How are urinary tract infections treated?

If your family doctor thinks you have a urinary tract infection, he or she will probably test a sample of your urine to find out if bacteria are in it. Sometimes, your doctor may not need to test your urine before treatment. If you have an infection, your doctor will then prescribe an antibiotic for several days or longer. Usually, symptoms of the infection go away a day or two after you start taking the antibiotic. Make sure you take all the medicine, even if you are feeling better.

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 colours your urine bright orange, so don't be alarmed by the colour when you void.

Drinking cranberry juice and extra fluids can also help.

How serious are urinary tract infections?

Urinary tract infections can be painful. But today's medicines keep urinary tract infections from becoming a serious threat to your health.

The kidneys can also be infected, which can be a more serious problem. Kidney infections usually require an antibiotic for a longer period of time and are sometimes treated in hospital.

What can I do if I have frequent infections?

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 on preventing urinary tract infections

  • Drink plenty of water to flush out bacteria. Drinking cranberry juice may also help prevent urinary tract infections. However, if you are taking warfarin, check with your doctor before using cranberry juice to prevent urinary tract infections. Your doctor may need to adjust your warfarin dose or you may need to have more frequent blood tests.
  • 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.
  • Avoid using feminine hygiene sprays and scented douches, which may irritate the urethra.
  • 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.

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.

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.

REFERENCES

  1. Litza JA, Brill JR. Urinary tract infections. Prim Care 2010 Sep; 37(3) : 491-507, viii. Review.
  2. The National Kidney and Urologic Diseases Information Clearinghouse. Urinary Tract Infections in Adults. http://kidney.niddk.nih.gov/kudiseases/pubs/utiaadult/
  3. Dielubanza EJ, Schaeffer AJ. Urinary tract infections in women. Med Clin North Am. 2011 Jan;95(1) : 27-41. Review

 


 

This health education material was developed and adapted by The College of Family Physicians of Canada from online materials developed by The American Academy of Family Physicians, with permission. It is regularly reviewed and updated by family physician members of the CFPC Patient Education Committee, who refer to the current evidence-based medical literature. Support for this program has been provided by a grant to the CFPC Research and Education Foundation by Scotiabank.

These pages may be reproduced for not-for-profit educational purposes only.

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