Urinary Tract Infections (UTI)

KEY POINTS

  • Although urinary tract infections (UTIs) are common in women, recurrent UTIs (3 or more in 1 year) should be investigated further
  • Recurrent UTIs should be confirmed with urine tests, as other conditions can cause similar symptoms
  • Even though UTIs may cause bleeding, women with visible blood in the urine usually needs to be referred to a urologist for additional assessments
  • Pregnant women with bacteria in their urine need low dose suppressive antibiotics
  • Topical oestrogen decreases UTIs in post-menopausal women

MORE INFORMATION

What is a UTI (Urinary Tract Infection)?

A UTI is most commonly a bladder infection, caused by a bacteria. The most common bacteria causing this is E Coli. Occasionally, kidney infection also occurs.

What are the symptoms of a UTI?

Common symptoms include burning when passing urine, going to the toilet to pass urine more often than usual, and an increased urgency/need to pass urine. Sometimes, patients also report bladder pain.

When a kidney infection is present, chills, fever, and kidney pain can develop. This requires more urgent attention than a bladder infection.

What is ‘recurrent UTIs (Urinary Tract Infections)’?

A patient is said to have recurrent UTIs when she has three or more UTIs within a year, or two or more UTIs within six months.

What tests are done to confirm and investigate my reasons for developing UTIs?

The most common test to diagnose is UTI is a clean catch mid-stream urine, which is processed within 2 hours of collection. It will identify the bacteria, and help guide your antibiotic treatment. A follow up test post treatment will confirm that your UTI has been cleared after treatment.

Other tests, including blood tests as well as scans may be ordered by your GP or specialist, in order to investigate why you may be getting recurrent infections in the first place.

Are there risk factors for developing recurrent UTIs?

Yes, examples include people who are:

  • Immunosuppressed
  • On dialysis

Or have:

  • Poorly controlled diabetes
  • Spinal cord injury, multiple sclerosis or other significant nerve problems
  • Urinary or faecal incontinence
  • Problems emptying their bladder
  • Vaginal prolapse
  • Certain types of kidney stones
  • Urinary tract abnormalities

Or uses:

  • Spermicide and diaphragm
  • An indwelling urinary catheter on a long term basis

Do Cranberry or probiotics help?

Unfortunately, clinical studies so far haven’t found convincing evidence that these strategies work.

What are my treatment options?

After your infection has been cleared, your treatment thereon will depend on whether an underlying cause have been found (which may involve seeing a Woman’s Urologist to further investigate the cause, who will recommend your onward management options).

If no specific cause is found, you may be offered topical vaginal oestrogen if you are post-menopausal. There are also other strategies, including prophylactic (preventative) low dose antibiotic regimens.

When should I consider seeing a Woman’s Urologist?

It is a good idea to see a Woman’s Urologist if you have UTIs, when you have the following:

  • Spinal cord injury, multiple sclerosis or other significant nerve problems
  • Urinary incontinence
  • Problems emptying your bladder
  • Urinary troubles even when you don’t have an infection
  • Vaginal prolapse
  • Kidney stones
  • Urinary tract abnormalities or previous urological/gynaecological surgery, especially a past history of slings
  • Repeated kidney infections
  • Blood in the urine that you could see
  • Peeing gas bubbles within your urine stream
  • Infections that just never clears despite antibiotic treatments
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