Understanding urinary tract infections (UTI’s) | 9 min read

Urinary tract infections, commonly known as UTIs, are a widespread health concern that can affect anyone, though they are particularly common in women. This infection occurs when bacteria enter the urinary tract, leading to uncomfortable symptoms and, if left untreated, potentially more serious health issues. Understanding what causes UTIs, how to recognise the symptoms, and the available treatment options can help you manage and prevent this common condition.

What are urinary tract infections (UTIs)?

A urinary tract infection is an infection that can occur in any part of the urinary system, including the kidneys, bladder, ureters, and urethra. Most UTIs involve the lower urinary tract, which includes the bladder and urethra. The infection is typically caused by bacteria, with Escherichia coli (E. coli) being the most common culprit. UTIs can be painful and annoying, and in severe cases, they can lead to complications if not properly treated.

Symptoms of a UTI.

Recognising the symptoms of a UTI is crucial for early treatment.

Common symptoms include:

• A strong, persistent urge to urinate.
• A burning sensation during urination.
• Passing frequent, small amounts of urine.
• Cloudy or strong-smelling urine.
• Blood in the urine, which may appear red, bright pink, or cola-coloured.
• Pelvic pain, particularly in women.

Primary causes of UTIs in women.

UTIs are more common in women than in men due to several anatomical and lifestyle factors.

1. Shorter Urethra:

• Anatomical structure. Women have a shorter urethra than men, which means bacteria have a shorter distance to travel to reach the bladder. This makes it easier for infections to develop.

2. Sexual Activity:

• Intercourse. Sexual activity can introduce bacteria into the urethra, increasing the risk of a UTI. Women who are sexually active are more likely to develop UTIs.
• New sexual partner. Having a new sexual partner can increase the likelihood of a UTI due to exposure to different bacteria.

3. Post-Menopause:

• Decreased oestrogen levels. After menopause, the decrease in oestrogen levels can lead to changes in the urinary tract, including thinning of the vaginal walls, which may increase susceptibility to infections.
• Changes in vaginal flora. The natural balance of bacteria in the vagina can change after menopause, reducing the protective bacteria and allowing harmful bacteria to proliferate.

4. Use of Certain Birth Control Methods:

• Spermicides. Spermicides can irritate the skin, making it easier for bacteria to enter the urethra.
• Diaphragms. Using a diaphragm for birth control can put pressure on the urethra, leading to incomplete bladder emptying and increasing the risk of a UTI.

5. Pregnancy:

• Hormonal changes. During pregnancy, hormonal changes can alter the urinary tract, making it more prone to infections.
• Pressure on the bladder. The growing uterus can put pressure on the bladder, leading to incomplete emptying and increasing the risk of bacterial growth.

6. Personal Hygiene:

• Wiping incorrectly. Wiping from back to front after using the toilet can transfer bacteria from the anal area to the urethra, increasing the risk of infection.
• Douching or using feminine hygiene sprays. These practices can disrupt the natural balance of bacteria in the vagina, increasing susceptibility to UTIs.

7. Tight or Synthetic Clothing:

• Wearing tight clothing. Tight underwear or pants can trap moisture and create a warm environment that encourages bacterial growth.
• Synthetic fabrics. Non-breathable fabrics can prevent air circulation and retain moisture, promoting bacterial proliferation.

8. Urinary Retention:

• Holding urine. Holding urine for extended periods can lead to bacterial growth in the bladder. Incomplete emptying of the bladder, whether due to habit or other medical conditions, can also increase the risk of UTIs.

9. Use of Catheters:

• Indwelling catheters. Women who use urinary catheters are at a higher risk of developing UTIs because the catheter can introduce bacteria into the urinary tract.

10. Immune System Weakness:

• Chronic illnesses. Conditions that weaken the immune system, such as diabetes, can make it harder for the body to fight off infections, increasing the risk of UTIs.

By understanding these causes, women can take preventive measures, such as practicing good hygiene, staying hydrated, and urinating after sexual activity, to reduce the risk of developing UTIs. If symptoms of a UTI arise, it’s important to seek medical treatment promptly to prevent complications.

How is a UTI diagnosed?

Diagnosing a UTI typically involves a visit to a healthcare provider, who may ask about your symptoms and medical history. The diagnosis is usually confirmed through a urine test, which checks for the presence of bacteria, red blood cells, or white blood cells. In some cases, further testing, such as a urine culture or imaging, may be required to rule out other conditions or to identify the specific bacteria causing the infection.

Treatment options for a UTI.

UTIs are generally treated with antibiotics, which are effective in eliminating the infection. The type of antibiotic and duration of treatment depend on the severity of the infection and your medical history.

This is what the treatment process might include:

• Antibiotics. Most UTIs are treated with a course of antibiotics, which should be taken as prescribed, even if symptoms improve before the medication is finished.
• Pain relief. Over-the-counter pain relievers like ibuprofen or acetaminophen can help alleviate discomfort associated with UTIs.
• Hydration. Drinking plenty of water helps flush bacteria from the urinary system and supports recovery.
• Follow-up. It’s important to follow up with your healthcare provider if symptoms persist or recur after treatment.

Preventing urinary tract infections.

Preventing UTIs involves adopting certain habits and lifestyle changes to reduce the risk of infection.

Some effective prevention strategies include:

• Stay hydrated. Drinking plenty of fluids, especially water, helps dilute your urine and ensures that you urinate more frequently, flushing bacteria from your urinary tract.
• Practice good hygiene. Wiping from front to back after using the toilet can help prevent bacteria from spreading to the urethra.
• Empty your bladder after intercourse. This can help clear any bacteria that may have been introduced during sexual activity.
• Avoid irritating feminine products. Using products like deodorant sprays, douches, or powders in the genital area can irritate the urethra, increasing the risk of a UTI.

How do UTIs manifest in men?

While we have established that UTIs are less common in men than in women, they can still occur and typically involve the lower urinary tract, including the bladder and urethra.

Here’s how UTIs manifest in men:

Common Symptoms:

• Frequent urination. An increased need to urinate, often with only small amounts of urine being passed.
• Burning sensation during urination. A painful, burning feeling when urinating is a hallmark symptom of a UTI.
• Cloudy or foul-smelling urine. The presence of bacteria can cause urine to appear cloudy or have a strong, unpleasant odour.
• Blood in the urine. Haematuria, or blood in the urine, may occur, giving the urine a pink, red, or cola-coloured appearance.
• Lower abdominal or pelvic pain. Men with UTIs may experience pain or discomfort in the lower abdomen, pelvic area, or rectum.
• Urethral discharge. In some cases, men may notice a discharge from the urethra.

Complications and Severe Symptoms:

• Prostatitis. A UTI can lead to prostatitis, an inflammation of the prostate gland, causing symptoms such as groin pain, discomfort during ejaculation, and flu-like symptoms.
• Upper urinary tract infection. If the infection spreads to the kidneys, it can lead to more severe symptoms such as fever, chills, nausea, vomiting, and back or side pain.

Diagnosis and Treatment:

UTIs in men are typically diagnosed through a urine test to detect the presence of bacteria or other signs of infection. Treatment usually involves antibiotics, and the specific type and duration of treatment depend on the severity of the infection. It’s important for men to seek medical attention promptly if they suspect a UTI, as untreated infections can lead to complications.

What causes UTIs in men?

Several factors can increase the risk of men developing an infection.

Here are some of the primary causes:

1. Urinary Tract Obstruction:

• Enlarged prostate. As men age, the prostate gland can enlarge (a condition known as benign prostatic hyperplasia, or BPH), which can obstruct urine flow and create an environment where bacteria can grow, leading to a UTI.
• Kidney stones. Stones in the urinary tract can block the flow of urine, contributing to bacterial growth and infection.

2. Catheter Use:

• Indwelling catheters. Men who use urinary catheters are at a higher risk of developing UTIs because the catheter can introduce bacteria into the urinary tract.
• Intermittent catheterisation. Repeated catheterisation, even if done temporarily, can also increase the risk of a UTI.

3. Sexual Activity:

• Unprotected intercourse. During sexual activity, bacteria can be introduced into the urethra, leading to an infection.
• Anal intercourse. Men who engage in anal intercourse without protection are at a higher risk of introducing bacteria into the urethra.

4. Weakened Immune System:

• Chronic illnesses. Conditions like diabetes can weaken the immune system, making it harder for the body to fight off infections, including UTIs.
• Immunosuppressive drugs. Medications that suppress the immune system, such as those taken after an organ transplant, can increase the risk of UTIs.

5. Previous UTIs or Prostate Infections:

• Recurrent infections. Men who have had previous UTIs or prostatitis (inflammation of the prostate gland) are more susceptible to subsequent UTIs.
• Chronic prostatitis. Ongoing inflammation of the prostate can harbour bacteria, leading to recurrent urinary infections.

6. Uncircumcised Men:

• Foreskin issues. Bacteria can accumulate under the foreskin in uncircumcised men, potentially leading to infections if not properly cleaned.

7. Poor Hygiene:

• Inadequate genital hygiene. Failing to maintain proper hygiene can allow bacteria to enter the urinary tract and cause an infection.

8. Underlying Health Conditions:

• Structural abnormalities. Congenital or acquired abnormalities in the urinary tract can increase the risk of UTIs.
• Neurogenic bladder. Conditions that affect bladder function, such as spinal cord injuries or multiple sclerosis, can lead to incomplete emptying of the bladder and increase the risk of infection.

Understanding these risk factors can help in the prevention and early detection of UTIs in men. If a UTI is suspected, prompt medical evaluation and treatment are essential to prevent complications.

In conclusion, urinary tract infections (UTIs) are a common health issue that many people experience at some point in their lives. While they can be uncomfortable and inconvenient, understanding the causes, symptoms, and treatment options can make a big difference in managing this condition. UTIs can happen to anyone, but knowing what to look for and how to address them can help you take control of your health and prevent future infections.