Bladder Infection - Urinary Tract Infection

Overview, Causes, & Risk Factors

A urinary tract infection, also called a UTI, is an infection of the bladder. The bladder holds urine produced by the kidneys.

What is going on in the body?

The bladder and the urine it holds are normally free from bacteria and other organisms. A urinary tract infection occurs when organisms are introduced into the bladder. Bacteria from the skin may enter through the urethra. The urethra is the tube that carries urine from the bladder to the outside of the body. Organisms can also enter the bladder on urinary catheters.

Bacteria in the bladder are usually flushed out when the person urinates. If bacteria multiply faster than they can be removed, a UTI results.

UTIs are more common in women than in men. Women have a shorter urethra which allows easier access for bacteria.

What are the causes and risks of the condition?

The most common cause of a UTI is a bacteria called E. coli. These bacteria are normally present in the bowel and feces. They can be introduced into the bladder by sexual activity.

Following are some of the risk factors for developing a UTI:

advanced age

bladder abnormalities

blockage of the urethra by a tumor or enlarged prostate

diabetes

impaired bladder function

inadequate fluid intake

objects inserted into the bladder, such as a urinary catheter

poor hygiene

pregnancy

Symptoms & Signs

What are the signs and symptoms of the condition?

Following are the most common symptoms of a UTI:

frequent urination

painful urination

urgency, or the need to empty the bladder immediately

UTIs may also cause the following symptoms:

bloody, pink, or cloudy urine

fatigue

fever

nausea and vomiting

pain in the lower stomach, lower back, or sides

pain with sexual intercourse

shaking and chills

strong smelling urine

Older people with a UTI may have mental changes or confusion.

Diagnosis & Tests

How is the condition diagnosed?

Diagnosis of a UTI begins with a medical history and physical exam. The exam may include a pelvic exam in women and a rectal exam in men. The healthcare provider may order the following tests:

urethral cultures in men to see if the prostate is infected

urinalysis to look for protein or blood in the urine

urine culture to see what type of bacteria is involved

If infections occur repeatedly, more tests may be done. An intravenous pyelogram is an X-ray of the urinary tract. It is taken after a contrast agent is injected into the body. A cystoscopy allows the provider to use a scope to look into the bladder.

Prevention & Expectations

What can be done to prevent the condition?

Not all UTIs can be prevented. The following steps can lower a person's risk for UTI.

Always empty the bladder completely.

Always wipe from front to back after a bowel movement.

Avoid chemicals that may irritate the urethra, such as strong soaps.

Avoid going for long periods without emptying the bladder.

Don't sit in baths or hot tubs for long periods of time.

Empty the bladder after sexual intercourse.

What are the long-term effects of the condition?

Once treatment has begun, the symptoms of cystitis disappear within 24 hours. Antibiotics must be taken for the full course, though. If the UTI is not successfully treated, there may be kidney damage. Bacteria can spread into the bloodstream. This can cause a serious blood infection called sepsis.

Treatment & Monitoring

What are the treatments for the condition?

Following are some of the antibiotics that may be used to treat UTIs:

amoxicillin and clavulanate

cephalexin

ciprofloxacin

nitrofurantoin

sulfamethoxazole and trimethoprim

Phenazopyridine may be used to relieve painful urination and bladder spasms. Ibuprofen or acetaminophen may be used to reduce fever.

What are the side effects of the treatments?

Antibiotics may cause stomach upset, rash, and allergic reactions. Phenazopyridine turns the urine a bright orange color.

What happens after treatment for the condition?

Urinary symptoms usually clear up within the first 3 days of antibiotic therapy. If symptoms persist or worsen, the healthcare provider should be notified.

How is the condition monitored?

The healthcare provider may order a repeat urinalysis or urine culture to see if the UTI is gone. Any new or worsening symptoms should be reported to the healthcare provider.