What are UTIs?

A urinary tract infection (UTI) is an infection in any part of the urinary system. The urinary system is made up of 2 kidneys and two tubes called ureters, which join the kidneys to the bladder. The urinary system filters your blood to eliminate waste and excess fluid from your body (as urine, ‘wee’). Urine goes through the kidneys along the ureters and into the bladder. Urine is stored in the bladder until you get the urge to go to the toilet (urinate). Urine leaves the body through a tube called the urethra.

Infection most commonly occurs in the bladder (cystitis) but can also occur in the urethra (urethritis), the kidneys (pyelonephritis), or a combination of these. If untreated, UTIs can lead to kidney infection which can be very serious, so it’s important to visit your doctor for early management.

What are the signs and symptoms of UTIs?

If you have a UTI, you may:

• pass very small amounts of urine
• feel the need or ‘urge’ to pass urine frequently
• feel that the bladder is still full after passing urine
• feel unwell with nausea and fever
• experience confusion (more common in older adults)
• have pain stinging or a burning feeling when urinating
• have smelly, cloudy, dark or blood in the urine
• pain in the lower back or sides or feel uncomfortable in your lower abdomen

Signs of UTIs in children can also include:

• irritability
• day or night wetting in a child who has been toilet trained
• feeding problems in babies

What causes UTIs?

UTIs are caused by bacteria that enter the body through the urethra. The urethra tube is much shorter in females than males, and the vagina is a lot closer to the back passage (anus) where bacteria live. For these reasons, females have a higher risk of getting a UTI.

Am I at risk of a UTI?

While UTIs can happen to anyone, they are more common in females who are sexually active or menopausal, or have health conditions such as diabetes or urinary incontinence. Females who use spermicides or diaphragms as contraception are also at increased risk of UTIs, and may benefit from other contraceptive options if they get recurrent UTIs.

Some people at greater risk of developing urinary tract infections:

• Females — nearly 1 in 3 females will have a UTI that needs treatment before the age of 24.
• Males with prostate problems — an enlarged prostate gland can cause the bladder to only partially empty, raising the risk of infection.
• Older people — some medications and problems with incontinence mean that older people are more likely to get a UTI.
• People with urinary catheters — people who are critically ill and people who can’t empty their bladder are at a greater risk of infection.
• People with diabetes — changes to the immune system make people with diabetes more vulnerable to infection.
• Infants — babies in nappies commonly get UTIs, in particular, infants born with physical problems (congenital abnormalities) of the urinary system are at greater risk.

When should I see my doctor?

If you have any symptoms associated with a UTI or a pre-existing health condition, don’t delay visiting your doctor for treatment.

UTIs can be more dangerous if you’re pregnant, due to an increased risk of kidney involvement. See your doctor if you are pregnant and you think you have a UTI, even if your symptoms are mild.

Children with UTI symptoms should see a doctor, to check for a more serious underlying condition.

Bladder infections may spread to your kidneys (pyelonephritis). This is a serious infection and needs immediate treatment with antibiotics. Signs and symptoms of kidney infection include fever, back pain, diarrhoea and vomiting. If you have these symptoms, it is important to see your doctor.

How are UTIs diagnosed?

Your doctor will examine you, and ask you for a urine sample for testing. This will help to identify the cause of the infection and determine the correct treatment

How are UTIs treated?

If your doctor prescribes antibiotics to treat your bacterial infection, remember to take the full course even if you are feeling better.

Urinary alkalinisers can help relieve discomfort when passing urine, and improve symptoms such as stinging. You can make your own by mixing one teaspoon of baking soda or bicarbonate of soda in water, or ask your pharmacist if you prefer to buy one ready made. Please check with your doctor or pharmacist if you can use them together with other medicines you take.

How can I prevent UTIs?

If you have repeated UTIs, try these self-help measures to prevent recurring infections:

• Drink more fluids to help flush out bacteria.
• Urinate as soon as you feel the need.
• Urinate immediately after intercourse.
• Gently wipe from front to back after urinating to reduce the transfer of bacteria to your vagina.
• Wear cotton underwear and loose-fitting pants.
• Find an alternative method of birth control if you use spermicides.
• Don’t use perfumed soaps, talcum powder or deodorant around the genital area.
• Avoid constipation.
• Use lubricant gel with intercourse if the vaginal area is dry.

There is conflicting evidence for drinking cranberry juice to prevent UTIs. If you want to try cranberry products, ask your doctor for advice.

If infections are an ongoing problem, you may need to be referred to an urologist (a doctor specialising in urinary problems) for further treatment.