An in-depth report on the causes, diagnosis, treatment, and prevention of urinary tract infections.
Cystitis; UTI; UTIs
Urinary Tract Infections (UTIs)
Urinary tract infections (UTIs) are a common type of infection caused by bacteria (most often E. coli) that travel up the urethra to the bladder. A bladder infection is called cystitis. If bacterial infection spreads to the kidneys and ureters, the condition is called pyelonephritis. Cystitis is considered a lower urinary tract infection. Pyelonephritis is an upper urinary tract infection and is much more serious.
Women are more susceptible to UTIs than men, and their infections tend to recur. One reason is that the urethra (the tube that carries urine away from the bladder) is shorter in women than in men. Frequent sexual intercourse also increases a woman's risk of developing UTIs. Contraceptive spermicides and diaphragms are additional risk factors. When women reach menopause, the decrease in estrogen thins the lining of the urinary tract, which increases susceptibility to bacterial infections.
Pregnancy does not increase the risk of getting a UTI, but it can increase the risk of developing a serious infection that could potentially harm the mother and fetus. Pregnant women should report any symptoms of UTIs to their doctors, and should get screened and treated for asymptomatic bacteriuria (presence of significant numbers of bacteria in the urine without symptoms).
Symptoms of UTIs may include:
- Strong urge to urinate frequently, even immediately after the bladder is emptied
- Painful burning sensation when urinating
- Discomfort, pressure, or bloating in the lower abdomen
- Pain in the pelvic area or back
- Cloudy or bloody urine, which may have a strong smell
A urine test can determine if these symptoms are caused by a bacterial infection. Antibiotics are used to treat UTIs. Older people may have a urinary tract infection but have few or no symptoms.
Antibiotics are used to treat UTIs. Most cases of UTIs clear up after a few days of drug treatment, but more severe cases may require several weeks of treatment.
Guidelines recommend using nitrofurantoin or trimethoprin-sulfamethoxazole as first-line antibiotic treatments for UTIs. Fluoroquinolones (such as ciprofloxacin) are now only recommended when other antibiotics are not appropriate.
Cranberries for UTI Prevention
Cranberry juice appears to offer little benefit for preventing recurrent UTIs, according to a review by the Cochrane Collaboration. Other studies have suggested that cranberry products may be helpful by preventing harmful bacteria from attaching and sticking to urinary tract cells.
Male Circumcision and UTIs
Babies rarely get UTIs but when they do, these infections are much more common in boys than in girls. A recent policy statement from the American Academy of Pediatrics (AAP), and a review of research studies in the Journal of Urology, indicate that boys who are circumcised are far less likely to get UTIs during their first year of life than uncircumcised boys. While noting the many potential health benefits of male circumcision (including reduced risks for acquiring sexually transmitted diseases), the AAP recommends that the decision to circumcise should be left to parents, in consultation with their child's doctor.