Urinary Tract Infections: Q&A

Baptist Medical Group’s Dr. Cruit - Board certified urologist, M. Elizabeth Cruit, M.D., answers a few common questions about urinary tract infections, symptoms and prevention.

What is a urinary tract infection (UTI)?

Normally urine is sterile, so a urinary tract infection occurs when bacteria are able to enter and grow in the urinary tract. This can be confined to the bladder (cystitis or a bladder infection). Or it can involve the kidneys (pyelonephritis). Pyelonephritis tends to be more severe, involving fever and back pain.

Who commonly gets UTIs?

Really, anyone can get a UTI, but they are more common in women. Approximately 50 percent of women will experience a UTI.

When children or men develop a UTI, it is less common, and should more quickly raise concern about an underlying problem.

Risk factors for UTIs:

  • Bacteria involved in UTIs often come from the bowel, and E. coli is the most common. These are bacteria that are normally around but they invade the urinary tract for some reason.
  • The bacteria mentioned above is one reason why UTIs are more common in women. In women, there is a shorter distance from the rectum to the urethra, which is the tube from the bladder to the outside. This is what makes it easier for the bacteria to make it in to the urinary tract.
  • Incomplete bladder emptying will predispose people to infections. This can occur in men because of an enlarged prostate.
  • Impaired immune system due to medications or other medical problems such as diabetes.
  • Pregnancy
  • Sexual intercourse, particularly with the use of spermicides
  • In older women, menopause and a loss of estrogen leads to changes in the genital tissue and vaginal flora allowing bacteria to invade and multiply more easily. Women with bladder or uterine prolapsed may also not completely empty their bladder.
  • Older patients are more likely to require catheterization which can introduce bacteria.

What are the symptoms of UTI?

  • Increased frequency to urinate
  • An urgency to void
  • Burning or discomfort with urination
  • Feeling of incomplete emptying
  • Lower abdominal pain
  • Possibly even blood in the urine
  • Pyelonephritis may be associated with back pain and fever

If someone is experiencing these symptoms, what should they do?

You should go to your primary care provider to be evaluated. A primary care physician can check your urine for infection, prescribe antibiotics, and hopefully perform a culture of the urine to identify the type of bacteria and what antibiotics it is susceptible to.

These days, we have many resistant bacteria, and a urine culture allows us to identify which antibiotics will work for a particular infection instead of having to guess or have an infection not be effectively treated.

When should you see an urologist regarding UTIs?

Primary care physicians are very capable of treating simple UTIs. It is when a UTI becomes a “complicated UTI” or patients are having recurrent infections that a urologist becomes involved. A complicated UTI involves a resistant bacteria, urinary obstruction, kidney stones or abscess.

How does someone do their best to prevent a UTI?

  • Increase water intake
  • Urinate frequently and completely
  • Good hygiene
  • Shower instead of baths
  • Urinate before and after sex
  • Cranberry may help to prevent the ability of bacteria to adhere to the lining of the urinary tract
  • Vitamin C