Urinary tract infection (UTI)

A UTI is an infection of part of your urinary system. This includes infection of your bladder (cystitis) and your kidneys (pyelonephritis).

UTIs are very common and are often part of other lower urinary tract symptoms (LUTS). Anyone can get one including men, women and children.

UTIs are much more common in women and people assigned female at birth (AFAB), as they  have a shorter urethra than men. Around 50–60%  women will develop UTIs in their lifetimes, these urinary tract infections aren’t usually serious and may pass by themselves within a few days. They can be more serious if they spread to your kidneys or if they happen during pregnancy. They’re also more serious in people who have a suppressed (weakened) immune system.

UTIs in men tend to be more complicated and harder to treat.

UTIs are caused by bacteria entering your urinary tract. The most common way for this to happen is by bacteria spreading from your anus (bottom) to your urethra – the tube that carries urine out of your body. The bacteria then spread up your urethra to cause an infection in your bladder, and sometimes, your kidneys.

Bacteria can also enter your urinary tract via a catheter (a tube to drain urine from your bladder) or if you have surgery involving your bladder. Bacteria can also spread to your urinary tract via your bloodstream. This is more likely in people who have a weakened immune system.

The following are all risk factors for UTIs:

UTI symptoms can depend on which part of your urinary tract is affected. Cystitis is infection of your bladder. Cystitis symptoms can include:

• A sudden urge to pass urine
• Needing to pass urine more often than normal, including at night
• Pain, discomfort, burning or a stinging sensation when you pass urine
• Urine appearing cloudy or having a bad smell
• Blood in your urine
• Pain or discomfort in your lower abdomen

Feeling confused and generally unwell can be signs of a UTI in older women.

UTIs can sometimes spread to the kidneys. Symptoms of a UTI that’s spread to the kidneys may include:

• Pain or tenderness in your back
• Muscle aches and pains
• Fever of 37.9°C or above
• Shivering and chills
• Nausea and vomiting
• Feeling generally unwell

A GP can usually make a UTI diagnosis. The GP will talk to you about your symptoms and medical history. They will usually ask you to give a urine sample. This is to look for the presence of chemicals or blood in the urine, which can be signs of a UTI. They may also send the sample to be tested to check which bacteria have caused the infection.

Your GP may refer you to one of our specialists for further investigation. This is more likely if you have a complicated or recurrent infection. Further tests may include

• An ultrasound
• A CT scan
• A cystoscopy (a procedure to look inside your bladder)

Cystitis treatment

If you have an uncomplicated UTI, like cystitis, your GP will give you some advice on managing your symptoms. This may include taking painkillers and making sure you’re drinking enough fluids to avoid dehydration. our symptoms may clear up on their own within around 5 days.

Your GP may also prescribe antibiotics. Antibiotics for UTIs include nitrofurantoin and trimethoprim. You usually take these for around 3 days. Sometimes your GP may give you a delayed or ‘back-up’ prescription, to use if your symptoms get worse or don’t improve within 48 hours.

Treatment for complicated UTIs

If you have a kidney infection or other complicated UTI, you may be offered different types of antibiotic, such as ciprofloxacin. You’ll also need to take antibiotics for longer – usually 1 to 2 weeks.

If you experience a severe or recurring UTI, your GP may refer you to one of our consultant urologists.

There are several measures often suggested for helping to prevent UTIs. These include:

• Wiping from front to back after passing faeces (poo)
• Avoiding douching
• Not wearing tight-fitting underwear
• Avoiding delaying passing urine, including after sex
• Making sure you drink enough fluids

There isn’t any evidence to say that these measures do work. But if you keep getting UTIs, it may be worth giving them a try.

Cranberry juice has traditionally been advised as helping to prevent or treat UTIs. But there is also little evidence to support this. Again, if you get recurrent UTIs, you may wish to give it a try.