The Who, What and Why of the UTI

Janice Santos, M.D.

For a condition that is quite common, most people know very little about urinary tract infections and its impact on quality of life. It’s important to be able to identify UTI symptoms so you can get the treatment you need.

Here is some information I thought would be helpful to know.

What exactly is a UTI?

A UTI occurs when bacteria travel into the lower urinary tract (the bladder and/or urethra in women, and in men, the prostate) or the upper urinary tract (kidneys and ureters) or into both tracts. That is what causes symptoms.

What are the symptoms of a UTI?

When the UTI is only in the bladder and the lower urinary tract, common symptoms include pain and difficulty urinating, frequent urination and an urgent need to go to the bathroom. This is referred to as cystitis.  If the UTI is in the upper tract, in the kidneys, individuals will also complain of lower back pain and may have a fever.

Who is at a higher risk of developing a UTI?

  • Middle-aged women who have gone through menopause experience a decrease in the level of the hormone called estrogen, which can cause changes in the lining and tissue of the vagina and urethra, which can lead to UTIs.  This is why one in four post-menopausal women are at an increased risk of getting a UTI.  Other causes of UTIs in older women include incomplete bladder emptying, urinary incontinence, and pelvic organ prolapse (dropped bladder or uterus).
  • In sexually active women, a UTI can occur after sexual activity, especially for women who have multiple sex partners. Risk factors in sexually active women include the use of a diaphragm, spermicides, and intercourse frequency.
  • Older women tend to get bacteriuria, which is when bacteria is present in the urine, but bacteriuria does not usually cause a UTI or symptoms.  Taking estrogen pills to replace the lost estrogen is not helpful, but putting a topical estrogen (e.g. cream, ring or tablets) in the vagina may be beneficial.
  • Pregnant women are also at increased risk of developing a UTI.
  • Men suffer from UTIs much less than women but an enlarged prostate can cause a UTI in older men because an enlarged prostate prevents the bladder from emptying completely. Ten percent of men 65 years and older are at a higher risk of contracting a UTI.  
  • Other risk factors for developing a UTI include bladder or kidney stones or conditions such as diabetes, which are more prevalent in older patients.

How is a UTI diagnosed and what is the usual treatment?

A UTI is diagnosed through a urine test analysis. UTIs are treated using an antibiotic. The length of treatment can vary from three days to a more prolonged course of medication, depending on the severity of the infection.

If you happen to feel any symptoms, please call your doctor to make an appointment. Treatment is simple, but not treating a UTI can lead to further complications. Now that you know the who, what and why of a UTI, don’t hesitate to get help when you need it!

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