Urinary tract infections (UTIs) are among the most common bacterial infections affecting millions of people every year. Although many UTIs are straightforward to treat, they can cause significant discomfort and, if left untreated, may lead to more serious kidney infections or recurrent urinary tract problems.
Mr Hama Attar, Consultant Urologist and Senior Clinical Lecturer, shares what you need to know about UTIs.
What is a urinary tract infection?
A UTI is an infection that can affect any part of the urinary system, including the kidneys, bladder and the urethra (the tube that carries urine out of the body).
Most UTIs affect the bladder (cystitis) and are considered uncomplicated urinary tract infections. These usually respond well to antibiotic treatment.
In some cases, the infection can travel to the kidneys, causing pyelonephritis (kidney infection), which is more serious and requires urgent medical attention and sometime hospitalisation.
Most urinary tract infections are caused by bacteria, particularly Escherichia coli (E. coli), which normally lives in the bowel. These bacteria can enter the urinary tract and multiply, leading to infection.
Who gets urinary tract infections?
Anyone can develop a UTI, but some people are at higher risk of urinary tract infections.
Risk factors include:
- female gender (shorter urethra increases bacterial access to the bladder)
- pregnancy
- menopause
- diabetes
- kidney stones
- enlarged prostate
- urinary catheters
- incomplete bladder emptying
- previous UTIs
- sexual intercourse
- neurological conditions affecting the bladder
Women are significantly more likely to experience UTIs, with around half experiencing at least one urinary tract infection in their lifetime. Developing one to two episodes of infection per year can be considered normal in women.
Although UTIs are less common in men, they often require further investigations, especially if the infections are recurrent.
Symptoms of urinary tract infections
UTI symptoms can vary depending on which part of the urinary tract is affected.
Common symptoms of a bladder infection (cystitis) include:
- burning or stinging sensation when passing urine (dysuria)
- needing to urinate more often than usual (frequency)
- waking up at night to urinate (nocturia)
- sudden or urgent need to urinate (urgency)
- passing small amounts of urine, cloudy urine, strong-smelling urine, or blood in urine – either visible or detected on urine testing
- pelvic and lower abdominal (suprapubic) discomfort or pain
How are urinary tract infections diagnosed?
The diagnosis of UTI usually begins with a clinical assessment of symptoms and medical history.
Common UTI tests and investigations include urine dipstick test and urine culture (to identify which bacteria caused the UTI and to obtain an idea about what antibiotic to give based on cultures), blood tests to check for infection markers, ultrasound or CT scan, when the UTIs become more frequent, and cystoscopy (camera examination of the bladder in selected cases).
Identifying the underlying cause of UTIs is especially important in patients with recurrent urinary tract infections.
How are urinary tract infections treated?
Most uncomplicated UTIs are treated effectively with short courses of oral antibiotic. The choice and duration of antibiotic treatment depend on the severity of infections, type of bacteria identified, and antibiotic resistance patterns, previous UTIs, drug allergies and kidney infection. It is important to complete the full course of antibiotics, even if symptoms improve early.
Additionally, staying well hydrated can speed up the process of recovery. This can be achieved by trying to produce crystal clear urine at all times.
How are recurrent urinary tract infections treated?
Some patients experience recurrent UTIs, which can significantly affect their quality of life and considering preventative methods is key to reduce the frequency of UTIs.
Most recurrent UTIs often respond to low doses of antibiotics. Measures such as regular intake of cranberry juice/ tablets, D-Mannose, Hiprex with Vitamin C are usually helpful in reducing the UTI frequency.
In postmenopausal women, vaginal oestrogen therapy helps promote the growth of good bacteria which resist UTIs.
Causes of UTIs such as enlarged prostates in men and incomplete bladder emptying should be addressed too.
Other general measures include avoiding constipation, regular bladder emptying, wiping from front to back after using the toilet, urinating before and after sexual intercourse, controlling conditions which reduce immunity such as diabetes, and proper catheterisation (for patients who have catheters).
Patients with frequent UTIs should seek specialist assessment rather than relying on repeated antibiotic courses alone as these will increase the risk of bacterial resistance and limit the number of antibiotic options available to use.
When should I visit a urologist?
You should consider seeing a urologist for UTIs if they are recurrent and persist despite appropriate antibiotic treatment.
It is important as well to see a urologist if blood is seen in your urine or if kidney stones have been identified.
All men who develop UTIs should be investigated as men do not usually develop UTIs. Pregnant women with recurrent UTIs should also seek help.
Those who have structural abnormalities in the urinary tract should consult a urologist too.
A urologist can investigate the underlying cause and create a treatment plan to reduce future infections.
Private urinary tract infections treatment at Cromwell Hospital
Recurrent UTIs can be distressing and disruptive to day-to-day life. Early diagnosis and treatment can relieve symptoms quickly, reduce complications, and help prevent future infections.
At Cromwell Hospital, our urology team provide expert UTI diagnosis and evidence-based treatment for both simple and complex cases. We offer rapid access to experienced consultant urologists who can arrange swift urine testing and organise diagnostic scans and minimally invasive procedures to further investigate if required.
