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Urinary tract infections

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Dr. Sachin Shelke
Internal Medicine


Urinary tract infection or UTI occurs when bacteria infect several parts of the urinary tract. The most common type of UTI is a bladder infection, also known as cystitis. Kidney infection, known as pyelonephritis, is a less common but more serious UTI. UTI is a common condition, especially among women. More than half of women will have urinary tract infection at least once in their lifetime. Thought to be a condition that will eventually clear up, UTI can have severe long term complications. Here is your complete guide on the condition and why you should get adequate treatment for it.

UTI is a prevalent infection that affects 150 million people every year. One-third of women are diagnosed with this infection before 24, and half of the women develop this infection at least once before the age of 35. Thirty per cent of women suffering from UTI will develop recurrent urinary tract infections, also known as rUTIs.

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Urinary tract infection can be divided into four types depending on the area affected of the urinary system: 

  • Bladder: This condition is called cystitis.

  • Kidney: This condition is called pyelonephritis. 

  • Ureter: In this condition, the tubes taking urine from the kidney to the bladder are affected. 

  • Urethra: This condition is called urethritis.


One of the most glaring symptoms is an intense burning sensation when you pass urine. This burning is usually accompanied by pain around the abdomen (and sometimes the middle of the back) and the urge to pass urine very often. The uniqueness of this symptom is that you will want to pass urine but will often only pass a few drops or very little urine. Apart from that, you might experience generalized body pain, fever and fatigue. Other symptoms include:

  • Cloudy urine

  • Bloody urine (this is more common in younger women)

  • Foul odour to the urine

  • Nausea

  • Vomiting

  • Lower back pain.

  • Chills and night sweats

  • Reddened skin

  • Confusion (often seen in older adults)

Causes And Risk Factors


UTI or Urinary tract infection, simply put, is an infection of the urinary bladder. Caused due to infectious organisms entering the urinary tract and multiplying in the bladder, UTI is a very uncomfortable and painful condition; if left untreated, it can infect the kidneys.

The urinary tract consists of all the organs that help make urine and excrete it from your body, including the kidneys, ureters, urinary bladder and urethra. A urinary tract infection occurs when an infectious organism enters your urinary tract – usually through the urethra and causes an infection. Here's what you should know about urinary tract infections in children.

The most common UTI causing organisms are those found in your faeces; these organisms are naturally present in your stomach, but when they enter your urinary system, they cause an infection.

Risk Factors

UTI is more common in women than in men since their urethra is much shorter than that of a man – 4 centimetres in women as compared to 20 centimetres in men – making it easy for the organism to infect the bladder. Older adults and young children are more susceptible to get UTI. Older adults with Alzheimer’s disease have an increased risk of developing UTI.

The infection may spread to the urethra in a number of ways; some of them are:

    • Using unclean or common toilets

    • Lack of hygiene in children undergoing potty training

    • Not washing well after using the toilet

    • Can happen during sex, especially with a new sexual partner

    • Using a diaphragm or spermicides for birth control

    • A pregnant woman is more susceptible to an infection

    • If you have an enlarged prostate

    • Have diabetes or kidney stones

  • If you do not drink enough water

  • History of UTI

  • Changes in the live bacteria that live inside the vagina may occur due to menopause

  • Have recently had a catheter (a thin tube) put through the urethra into the bladder

  • Surgery of the urinary tract

  • Staying idle for a long time



It is better to take necessary precautions and prevent urinary tract infection from recurring rather than suffer from long-term complications. Here are some basic tips that can help you: 

  • Drink plenty of water

  • Consume cranberry juice

  • Eat vitamin C rich foods

  • Be cautious while having sex

  • Urinate before and after having sex

  • Drink sufficient water after sex to aid in urination

  • Do not hold urine longer than three or four hours

  • Clean your genitals every day

  • Avoid using skin products

  • Wear loose clothes

  • Practice good hygiene

  • Prefer taking a shower instead of baths

  • Avoid bath oils

  • Avoid or minimize using sprays and powders in the genital area

  • Teach children hygiene practices during potty training

  • Use oestrogen cream around the vagina after menopause

  • Avoid wearing tight-fitting pants

Few women may experience repeated bladder infections. In such cases, the doctor may suggest to:

  • Take a dose of antibiotic after sex

  • Take a cranberry supplement after sex

  • Use sanitary pads instead of tampons

  • Use oestrogen cream to prevent dryness caused by menopause

If a urine infection develops, the doctor may suggest taking an antibiotic course for three to fourteen days.


Diagnosis is first based on your symptoms. Your doctor will initially give you a few pain killers and antihistamines. In cases where a confirmation is required, you will be advised to get a urine test. This test will check your urine for the presence of pus cells and blood cells. In some cases, you will also be advised to get a urine culture, where the organism causing the infection is identified, and the antibiotic that will kill it will also be zeroed in on.

The doctor may also suggest the following tests to rule out other problems in the urinary system:

  • CT scan

  • Kidney ultrasound

  • Kidney scan

  • Intravenous pyelogram

  • Voiding cystourethrogram


UTI is normally treated with antibiotics, antipyretics (medicines that help bring down a fever) and pain killers. In severe cases, you may need to get an intravenous drip with antibiotics.

Treatment regimens as per the type of UTIs are, but mainly depends on urinary culture and sensitivity :

  • Cystitis: Nitrofurantoin, co-trimoxazole, and ciprofloxacin is generally recommended for five days. Alternatively, cefuroxime or cefixime can also be prescribed for five days.

  • Pyelonephritis: Piperacillin tazobactam and ertapenem are given intravenously for seven and ten days, respectively. Alternatively, imipenem or amikacin can be given intravenously for ten days.

  • Prostatitis: Doxycycline, co-trimoxazole, and ciprofloxacin are prescribed for a period of three to five weeks. Alternatively, piperacillin, cefoperazone, ertapenem, or meropenem can be given intravenously.

Older adults; patients with kidney stones; patients who recently had urinary tract surgery; patients with diabetes, cancer, spinal cord injury, or multiple sclerosis; and pregnant women are more likely to get admitted to the hospital for urinary tract infection. Patients may require surgery where the condition occurs due to problems in the structure of the urinary tract.

Antibiotics may lead to side effects ranging from minor side effects like a rash or severe side effects like diarrhoea, severe colon damage, and death. Antibiotics resistance may also occur in few patients. Contact the doctor if you develop any side effects while using antibiotics.


  • Complete the course of antibiotics even after the symptoms of urinary infection go away to avoid antibiotics resistance.

  • Drink plenty of water.

  • Avoid alcohol and caffeine as they irritate the bladder.

Prognosis And Complications


Most of the symptoms of UTIs often disappear with 24 to 48 hours after beginning the treatment. However, kidney infection lasts for more than a week.

Typically, UTI is easily curable with medication. But if ignored, the infection can spread to the kidneys and infect them, making it a hazardous condition. Studies have also found that repeated UTI infections can lead to the formation of kidney stones known as ‘struvite stones. Here are five common complications of urinary tract infection:

  • Recurrent urinary tract infections

  • Kidney infections (pyelonephritis)

  • Kidney damage 

  • Kidney scarring

  • Sepsis (This complication is quite common in older adults, younger children, HIV patients, or patients receiving chemotherapy for cancer).

  • Complications of pregnancy

  • Prostatitis

Alternative Treatments

Here are few effective home remedies to treat UTI.

Non-anti-microbial therapy can be considered in cases of antibiotic resistance or failure to remove the infection entirely. Following is the list of non-anti-microbial treatments: 

  • Urinary alkalization: In this therapy, alkalinizing agents like potassium citrate are administered to the patients.

  • Lactobacillus probiotics: This therapy is used to form a vaginal barrier to the infecting bacteria.

  • Topical oestrogen: This therapy is used to prevent the risk of rUTIs.

However, it is essential to consult the doctor before initiating any treatment for UTI. 


  1. Urinary tract infection. CDC. Available at: Accessed on Apr 1, 2021.

  2. Urinary tract infection. OASH. Available at: Accessed on Apr 1, 2021.

  3. Urinary tract infection – adults. MedlinePlus. Available at: Accessed on Apr 1, 2021.

  4. Urinary tract infection in women - self-care. MedlinePlus. Available at: Accessed on Apr 1, 2021.

  5. Treatment guidelines for antimicrobial use in common syndromes. ICMR. Available at: Accessed on Apr 1, 2021.

  6. Abou Heidar NF, et al. Management of urinary tract infection in women: A practical approach for everyday practice. Urol Ann. 2019 Oct-Dec;11(4):339-346.


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