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Understanding Urinary Tract Infections: What You Need to Know

A urinary tract infection, or UTI, is an infection in any part of your urinary system. Your urinary system includes your kidneys, ureters, bladder, and urethra. Most UTIs happen in the bladder and urethra, which are the lower parts of your urinary system. According to the National Institute of Diabetes and Digestive and Kidney Diseases, about 150 million people worldwide get a UTI each year. In the United States alone, UTIs account for nearly 8.1 million visits to healthcare providers annually.

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UTIs happen when bacteria get into your urinary tract and multiply. The bacteria that most often causes UTIs is called E. coli, which normally lives in your digestive system and on your skin. When this bacteria enters your urethra and travels upward, it can cause an infection. Women are more likely to get UTIs than men—about 40% to 50% of women will have at least one UTI in their lifetime, compared to about 3% to 10% of men. This difference exists partly because women have a shorter urethra, which makes it easier for bacteria to reach the bladder.

There are different types of UTIs depending on where the infection is located. A bladder infection is called cystitis. A urethra infection is called urethritis. A kidney infection, called pyelonephritis, is more serious and requires prompt medical attention. Understanding which type of UTI you might have helps you know when to see a doctor and what to expect during treatment.

Common risk factors for getting a UTI include being female, sexual activity, certain types of birth control, pregnancy, menopause, urinary tract abnormalities, spinal cord injuries, catheter use, and a weakened immune system. Age also plays a role—UTI rates increase in older adults, particularly in women over 50. Knowing your personal risk factors can help you understand whether you should watch for UTI symptoms and when to contact a healthcare provider.

Practical Takeaway: Learn your personal risk factors for UTIs so you can recognize symptoms early. If you have recurring infections or are in a high-risk group, discuss prevention strategies with your healthcare provider.

Recognizing UTI Symptoms and When to Seek Care

Recognizing UTI symptoms is important because they can vary depending on which part of your urinary system is infected and your age. Common symptoms include a strong urge to urinate frequently, a burning feeling when you urinate, cloudy, dark, or bloody urine, pain or pressure in your lower abdomen or lower back, and urine that has a strong odor. In older adults and people with catheters, symptoms may be different. Older people might experience confusion, fever, or difficulty with urination instead of the typical burning sensation. People with spinal cord injuries might notice only increased spasticity or discomfort.

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Lower UTI symptoms—those affecting the bladder and urethra—typically include dysuria (pain with urination), frequency (going to the bathroom more than 8 times in 24 hours), urgency (a sudden need to urinate), and suprapubic pain (pain above the pubic bone). These symptoms can develop over a few hours or days. Many people with a lower UTI do not have fever. The symptoms are uncomfortable but often manageable while you arrange to see a healthcare provider.

Upper UTI symptoms are more serious and involve your kidneys. These symptoms include fever (usually 102°F or higher), chills, nausea, vomiting, flank pain (pain in your side below the ribs), and back pain. If you have these symptoms along with any lower UTI symptoms, you should contact a healthcare provider promptly. A kidney infection can become serious and lead to complications if not treated.

Timing matters when deciding to contact a doctor. If you have lower UTI symptoms, contact your healthcare provider within a day or two. If you have symptoms of a kidney infection—fever, nausea, vomiting, or severe back pain—contact a healthcare provider the same day or seek urgent care. Pregnant women with any UTI symptoms should contact their provider right away because UTIs during pregnancy can lead to complications. Men with UTI symptoms should also see a healthcare provider promptly because UTIs in men are less common and may suggest another underlying condition.

Practical Takeaway: Write down your symptoms, when they started, and any other health changes before calling your doctor. This information helps your provider understand your situation better and determine the right next steps for you.

How Healthcare Providers Diagnose Urinary Tract Infections

Diagnosing a UTI involves more than just describing your symptoms. Your healthcare provider will typically ask detailed questions about your symptoms, how long you've had them, whether you've had UTIs before, your medical history, and current medications. They'll also ask about your urinary and bowel habits, any recent sexual activity, and whether you're pregnant. This information helps them understand your situation and determine whether testing is necessary.

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The primary test for diagnosing a UTI is a urinalysis, where a sample of your urine is examined in a laboratory. For this test, you provide a midstream clean-catch urine sample, which means you clean your genital area before urinating and collect urine from the middle of your stream. This method reduces the chance of contamination from bacteria on your skin. The laboratory looks for white blood cells, red blood cells, nitrites, and leukocyte esterase—all signs that suggest an infection. A urinalysis can usually be done in a doctor's office or urgent care clinic and results often come back within a few hours.

If your urinalysis suggests a UTI, your healthcare provider may order a urine culture. A culture grows any bacteria found in your urine to identify exactly what type of bacteria is causing the infection and which antibiotics will work best against it. A culture takes longer than a urinalysis—typically 48 to 72 hours—but it provides important information for treatment, especially if you have a severe infection, a kidney infection, or recurring UTIs. Your provider might start treatment based on your symptoms and urinalysis while waiting for culture results.

In some cases, your healthcare provider may order additional tests. An ultrasound or CT scan of your abdomen and pelvis might be done if you have a fever, signs of a kidney infection, or if you're a man with a first-time UTI, as this can indicate an underlying structural problem. For people with recurring UTIs, your provider might recommend tests to check your urinary system's structure and function. These tests help identify why infections are happening repeatedly and guide prevention strategies.

Practical Takeaway: Prepare a clear midstream urine sample as instructed by your healthcare provider's office. Keep a list of any medications or supplements you take, as some can affect urinalysis results and your treatment options.

Treatment Options and What to Expect During Recovery

Treatment for UTIs typically involves antibiotics, which are medications that kill the bacteria causing the infection. The specific antibiotic your healthcare provider chooses depends on the type of bacteria found in your urine culture, the location of your infection, and whether you have any allergies or other health conditions. Common antibiotics for uncomplicated UTIs include trimethoprim-sulfamethoxazole (TMP-SMX), nitrofurantoin, and fluoroquinolones. Most lower UTIs are treated with oral antibiotics taken by mouth for 3 to 7 days, depending on the medication and your situation.

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For kidney infections, treatment is more intensive. You may need to take antibiotics for 7 to 14 days, and your healthcare provider might recommend that you start with intravenous (IV) antibiotics in a hospital or urgent care setting, especially if you have high fever, severe nausea and vomiting, or signs of sepsis. Oral antibiotics can usually continue at home once your symptoms improve. Your healthcare provider will give you specific instructions about when to take your medication, what to avoid while taking it, and when to follow up.

During treatment, you should start feeling better within a few days. Pain and burning with urination usually improve first, followed by reduced urinary frequency and urgency. Fever typically breaks within 24 to 48 hours of starting antibiotics. However, it's important to take all of your prescribed antibiotics even after your symptoms improve. Stopping early can allow bacteria to survive and cause the infection to come back or develop antibiotic resistance.