Ultimate Guide: UTI

A urinary tract infection (UTI) is an infection that affects any part of the urinary system, such as the kidneys, ureters, bladder, or urethra. 

UTIs are extremely common, especially in women, and are typically caused by bacteria that enter the urinary tract. While uncomfortable with symptoms like a frequent urge to urinate and burning during urination. 

In this comprehensive guide, we will examine UTIs in greater detail, including their causes, risk factors, symptoms to watch for, and diagnosis. We will also discuss the most effective treatments and medications for quickly eliminating a UTI.

At e-Surgery, we always aim to inform our readers, educate them on infections such as UTIs, and provide advice for dealing with such conditions.

What Is A UTI?

A UTI (urinary tract infection) is an infection that can occur in any part of the urinary system and can affect the kidneys, ureters, bladder, or urethra. Bacteria typically cause UTIs, though fungi can also cause infections in some cases. 

UTIs are one of the most common types of infections, accounting for over 800,000 admissions to UK hospitals over recent years. While both men and women can develop UTIs, they are significantly more prevalent in women.

There are different types of UTIs based on the location of the infection:

• Cystitis (Bladder Infection)
• Urethritis (Urethral Infection)
• Pyelonephritis (Kidney Infection)

Most UTIs are cases of cystitis, a bladder infection. However, if left untreated, the bacteria can travel up the urinary tract and cause more severe kidney infections.

So, how do you get a UTI? The most common causes are the transfer of bacteria from the digestive tract to the urethra, often from improper wiping after a bowel movement. 

In addition, sexual intercourse can also introduce bacteria into the urinary tract. Other risk factors include pregnancy, menopause, diabetes, catheter use, and an impaired immune system.

While annoying and uncomfortable, UTIs are usually not serious if treated promptly with antibiotics. However, complications like kidney damage and recurrent infections can occur without proper UTI treatment.

Symptoms of UTI

The classic symptoms of a urinary tract infection (UTI) include:

• Burning or painful sensation when urinating (dysuria)
• Frequent and intense urges to urinate (urgency)
• Passing small amounts of urine
• Cloudy, bloody or foul-smelling urine
• Pelvic pain or pressure 

Symptoms of a bladder infection (cystitis) often occur suddenly and can be uncomfortable. UTI symptoms in women frequently include burning with urination, pelvic pressure, and needing to urinate frequently or urgently. 

If the infection spreads to the kidneys (pyelonephritis), additional symptoms may develop, such as:

• Back or groin pain
• Fever, chills, nausea and vomiting
• Fatigue and feeling generally ill

In the elderly, UTI symptoms can be quite different and include confusion, agitation, dizziness, and muscle aches rather than typical urinary issues.

It's also possible for some people, especially older adults and those with diabetes, to have asymptomatic UTIs with no apparent symptoms at all.

While uncomfortable, this list of UTI symptoms in women (and men) can help indicate when to get checked out to confirm a urinary tract infection and get proper antibiotic treatment.

Diagnosis of UTI

To diagnose a urinary tract infection, your doctor will first ask about your symptoms and perform a physical exam. Then, they will test a urine sample for bacteria and white blood cells that indicate an infection.

There are a few different tests that may be used:

• Dipstick test: A strip is dipped into the urine sample to check for nitrites and leukocyte esterase produced by bacteria.
• Urinalysis: The lab examines the urine sample under a microscope to check the red and white blood cells and bacteria levels.
• Urine culture: A small amount of urine is allowed to grow bacteria overnight so it can be identified and tested for the most effective antibiotics.

A positive dipstick and urinalysis are usually adequate for simple UTIs for diagnosis and treatment. However, a urine culture may be required for more complicated or recurrent UTIs.

Additional diagnostic imaging, like an ultrasound, is only done if there are concerns about complications or the possibility of kidney stones or other abnormalities.

UTI Medicine & Treatments

The primary treatment for urinary tract infections (UTIs) is antibiotics to eliminate the bacterial infection. Some of the most commonly prescribed antibiotics for UTI include:

• Nitrofurantoin: An antibiotic for treating lower UTIs like bladder infections.
• Trimethoprim: This antibiotic is used to treat kidney and bladder infections. 
• Fosfomycin: A single-dose antibiotic for an uncomplicated UTI.
• Cephalexin: Cephalosporin antibiotic is used to treat all types of UTIs, from bladder to kidney infections.
• Ciprofloxacin: Fluoroquinolone antibiotic reserved for more complicated UTIs that are resistant to other antibiotics.
• Levofloxacin: This is another fluoroquinolone prescribed for kidney infections and severe UTIs.

Typical dosages range from a single dose of fosfomycin to 3-7 days of antibiotic treatment for bladder infections. More serious kidney infections may require 7-14 days of antibiotics.

Phenazopyridine is another medication that can provide symptom relief for painful urination but does not treat the underlying UTI itself.

Hospitalisation and IV antibiotics may be needed for severe or resistant infections. Surgery is rarely required except to remove infected kidney stones or correct anatomical abnormalities that contribute to recurring UTIs.While UTI antibiotics are the standard treatment, some people like to try home remedies like drinking unsweetened cranberry juice or taking probiotics to help prevent infections. However, these are not recommended for treating active UTIs.

Next Steps

Even with antibiotic treatment, about 25% of women experience a second UTI within 3-6 months of their first. If you are getting frequent recurrent UTIs, your doctor may take additional steps:

• Order a CT scan to check for anatomical abnormalities
• Prescribe low-dose vaginal estrogen if you are postmenopausal 
• Recommend taking daily or post-intercourse antibiotics prophylactically
• Test for antibiotic-resistant bacteria

To help prevent future urinary tract infections, it's best to:

• Drink plenty of water to flush out bacteria
• Wipe from front to back after bowel movements
• Urinate before and after sexual intercourse
• Avoid potentially irritating feminine hygiene products
• Wear breathable cotton underwear and looser pants

For postmenopausal women, vaginal estrogen therapy can help restore healthy levels of protective bacteria. Cranberry supplements may also help reduce UTI risk, though the evidence is mixed.

While UTIs are incredibly common, they shouldn't be ignored, as they can potentially lead to more severe kidney infections. Getting prompt antibiotic treatment and taking steps to prevent recurrences is important.

If you experience any severe UTI symptoms like fever, nausea, or flank pain, it's critical to seek medical care right away. With proper treatment and prevention, uncomplicated UTIs can be quickly cleared up. Anyone who believes they have symptoms of a UTI or has any further questions about the infection or any other bacterial infections should not hesitate to contact certified pharmacists by following this link.