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  • Post published:10/08/2020
  • Post last modified:13/07/2021

Urinary  Tract  Infection  (UTI) is defined as the infection of any part of the  Urinary system i.e. the  Urethra, Urinary bladder, Ureters or the  Kidneys. These infections are quite common in women because of the short length of the urethra  &  the proximity of the urethral opening to vagina &  anal opening.

How does Urinary Tract Infection develop?

Causes of UTI :

UTI  develops when infective organisms invade the various parts of the  Urinary tract. To begin with, they may affect the urethra, and if the infection remains uncontrolled,  they may ascend upwards to invade the  Urinary bladder,  ureters or even the  Kidneys.  The  factors  which  aggravate  the  risk  of  UTI’s  in  women  include:

  • Female anatomy–  As discussed above,  the close  association between  the  female  urethra,  vagina  &  anal  region  increases  the  likelihood  of  spread  of  bacteria from  vaginal  or  gastrointestinal  tract  to  the  urinary  Moreover, the  short  urethra in  women  decreases  the  distance  that  the  bacteria  need  to  travel  in  order  to  reach  the  urinary  bladder . Thus,  the  incidence  of  UTI’s  is  more  in  women  as  compared  to  men.
  • Sexual activity –  Sexual  activity  increases  the  chances  of  UTI  especially,  if  there  are  multiple  sexual  Women  are  more  prone  to  sexually  transmitted  infections  &  the  organisms  may  be  transmitted  from  the  genital  region  to  the  urethra  by  the  contact  with  fingers/genitals/other  devices.
  • Certain contraceptive measures –   Certain  birth  control  measures  such  as  using  the  Diaphragm  or  spermicidal  agents  can  increase  the  chances  of
  • Pregnancy- UTI’s  are  common  in  pregnancy,  the  risk  begins  at  6  weeks   &  peaks  at  about  22-24  weeks  of    The  reason  is  the  relaxation  of  smooth  muscles  in  response  to  pregnancy  hormones  and  the  resultant  increase  in  volume of urinary  bladder,  accompanied  by  urinary stasis ( decreased  urinary  flow rate ).  This  also  leads  to  increased  episodes  of  urinary  reflux  i.e.  backward  flow  of  urine  from  the  bladder   into  the  ureters  or  even  kidneys  occasionally. All  these  factors  increase  the  chances  of  development  of  UTI  in  pregnancy.
  • Menopause- After  menopause,  the  circulating  levels  of  Oestrogen  in  the  body  decrease  and  this  leads  to  changes  in  the  mucosal  lining  of  the  urinary  &  genital  tract  that  increases  the  chances  of infections.
  • Obstruction to  urinary  flow –  This  maybe  due  to  certain  abnormalities  of  the  urinary  tract  or  presence  of  stones  ( calculus) in  urinary  tract,  which  may  prevent  smooth  forward  flow  of  urine  and  may  predispose  to
  • Low Immunity  –  A decreased  immunity,  for  e.g.  in  women  with  Diabetes  or  HIV  infection,  increases  the  chances  of
  • Recent Urinary  / Genital  procedure-  Any  surgical or  interventional  procedure  involving  the  urinary  tract  or  sometimes  the  genital  tract  also  may  increase  the  possibility  of  UTI
  • Others- Other  causes  like  a neurological  condition ,  history  of  previous  urinary  infections    may  also  increase  a  woman’s  chances  of  developing  UTI.

How do I know if I have UTI ?

Symptoms of Urinary Tract Infections :

Urinary  tract  infections  may  sometimes  cause  no  symptoms   but  mostly,  a  woman  gets  one  or  more  of  the  following  signs/symptoms :

  • Urgency- There  may  be  a  strong  urge  to  urinate,  which  may  sometimes  be uncontrollable
  • Frequency- You  may  soon feel  the  need  to  urinate  again  even  though  you  have  passed  urine
  • Dysuria- There  may  be a pain  in  urethral  region  or  pelvis  while  urinating
  • Odour- The  urine  may  be  foul-smelling
  • Colour- Sometimes,  the urine may appear cloudy or maybe blood    Consult your doctor  if the urine appears  bloodstained.
  • Pelvic pain-  When  the  infection  reaches  the  bladder,  it  may  lead  to  pelvic  pain  or  pain  felt  in  the  lower  part  of  the
  • Flank pain-  Pain  in  the  upper  back  &  sides  may  be  a  sign  of  infection  in  the  kidneys  and  it  maybe  accompanied  by  fever,  chills,    Consult  your  doctor  immediately  if  you  develop  any  of  these.

The  gold  standard  for  diagnosing  a  Urinary  Tract  Infection  is  a Urine  test  for  routine  microscopy  and  a  Culture/Sensitivity test  to  check  for  the  presence  of  specific  infective  organisms  and  their  sensitivity  to  various  antibiotics.  A  culture/sensitivity  test  guides your  doctor  to  prescribe  the  most  effective  antibiotic  for  the  organism  causing  your  UTI.

How can UTI be treated ?

Urinary Tract Infection Treatment :

The  best  cure  for  a  urinary  tract  infection  is  to  take  relevant  antibiotics  for  the  prescribed  period  of  time  as  advised  by  your  doctor. However,  there  are  other  supportive  measures  that  need  to  be  followed  in  order  to  facilitate  relief  of  symptoms  &  complete  cure. Antibiotics  usually  lead  to  a  quick  relief  of  symptoms,  however,  you  must  continue  the  medications  for  the  complete  prescribed  duration  or  else  it  may  lead  to  incomplete  cure  of  UTI  which  may  then  flare  up  again  after  a  few  days  and  thus  may  lead  to  recurrent , resistant infections .

You  can  also  take  certain  supportive  measures  to  ease  your  discomfort  when you  have  UTI  :

  • Drink plenty  of  water :  Drink  at  least  8-10  glasses  of  water  as  water  helps  to  dilute  the  urine  and  hence  decreases  the  irritation  &  pain  in  the  urinary  tract.  It  also  helps  to  flush  out  the  toxins &  organisms  causing  the  UTI.
  • Avoid coffee/  tea  or  other  liquids  that  may  irritate  your bladder
  • Urinary alkalinises may  sometimes  be  prescribed  by  your  doctor  &  help  decrease  the
  • Avoid sexual  activity when  you  have  active
  • Cranberry juice,  Barley  water,  etc  help  ease  the  discomfort  but  the exact  benefit  afforded  by  these are  still unknown.
  • Use warm heating pads on lower abdomen  &  back to relieve the discomfort.    However,  make sure that the pads are not excessively hot.

What are the complications of UTI ?

Usually,  if treated properly,  UTI  does not cause any long term complications.  However, if  treated  incompletely,  or  in  a  person with  compromised  immunity,  it  may  lead  to  the  following  complications:

  • Recurrent infections-  Recurrent  UTI  is defined as the occurrence of  UTI  3 times or more in a  year.  Partially  treated  infections  or  in  cases  where  the  cause  for  the  primary  infection  persists  &  is  not  eradicated may  lead  to  recurrent
  • Kidney damage- Persistent  infection  or  a  very  acute  &  severe episode  of  UTI  may  sometimes  lead  to  permanent  kidney  damage  which  may  necessitate  a  prolonged  course  of
  • Preterm birth  –  Untreated  UTI  may  lead  to the onset  of  preterm  labour  &  delivery  leading  to  low  birth  weight  & a compromised  baby  who  may  need  Nursery  care  or  admission  to
  • Sepsis- Spread of infection all over the body may lead to serious complications  &  sepsis which may require hospital/ICU  admission.

How  can  UTI  be  prevented  ?

Prevention of Urinary Tract Infection :

UTI  can  be  prevented  by the following  measures  :

  • Drink plenty  of  liquids –  at  least  8-10  glasses  a  day
  • After urinating  or  passing  stools,  wipe  from  front  to  back,  to  prevent the spread  of  organisms  from the anal  region  towards
  • Avoid the use  of  spermicidal  jellies  or  diaphragms  for
  • Avoid multiple  sexual  partners
  • Ensure that  you  take complete  treatment  for  the first  episode  of    UTI  as  prescribed  by  your

 What is the role of ultrasound in the management of urinary tract infections?

Urinary tract ultrasound imaging is being used in cases of confirming UTI to evaluate the urinary tract anatomy and exclude any underlying pathology such as kidney stones, tumours and bladder problems.

In cases of chronic complications, ultrasound will evaluate any damaged caused to the kidneys from recurrent infections such as renal scarring or hydronephrosis.

Your doctor will probably refer you to your local hospital to have a kidney ultrasound scan but as the ultrasound NHS waiting times are along you can opt to have a private ultrasound instead. You can find more about the private urinary tract scans we offer at the exam page information.

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Medically Reviewed by Tareq Ismail Pg(Dip), BSc (Hons)