Urinary Tract Infection (UTI)

What are the most typical symptoms for UTIs?

Urinary urgency, frequency, and burning are the most prevalent UTI symptoms. Cloudy, malodorous urine or blood in the urine are also not uncommon. In addition, women often describe a sensation of not being able to fully empty their bladder when they urinate.

Does it matter if people have different combinations of symptoms?

There is no single symptom required for a diagnosis of UTI. Some individuals experience a constellation of symptoms, while others have just one vague sign (like cloudy urine). We don’t know exactly why some people have more severe symptoms than others; it’s likely just individual variation.

Why are men’s and women’s UTIs approached and treated differently?

Men have a much lower incidence of UTIs than women, primarily because of anatomical differences (it’s easier for bacteria to enter and ascend the urinary tract in a woman than a man). The initial choice of antibiotics for UTIs can sometimes differ by gender, depending on whether a provider suspects that a patient’s prostate is involved in the infection.

What about other demographics?

UTIs in pregnant women are a risk factor for premature birth, so they should be closely evaluated. Repeat testing should be performed after antibiotic treatment to make sure the infection has resolved.

UTIs in the elderly are common, and often develop without classic symptoms. If left untreated, they can progress into a condition called urosepsis, which is an infection of the blood that can be fatal.

Recurrent UTIs in children warrant evaluation for anatomical abnormalities in the urinary tract, including the kidneys. People with prior bladder surgeries or other conditions that affect their urinary tract may also be vulnerable to more frequent and severe infections.

What factors warrant closer attention or a different approach to treatment?

If bacteria ascend through the entirety of the urinary tract and into the kidneys, the infection warrants close attention. A kidney infection (the medical term is pyelonephritis) requires a specific type of antibiotic, and can lead to a very dangerous condition called sepsis if not treated. The hallmark of pyelonephritis is back pain, and it is often accompanied by fever.

Does having blood in the urine mean it’s a more serious infection?

No. When tissue lining the urinary tract becomes inflamed and irritated--as can happen with even a mild infection—it can bleed, and that blood then appears in the urine. In patients who have blood in their urine related to a UTI, it’s a good idea to do a urine test six weeks after treating the infection to make sure the blood is gone.

If blood is present in the urine without any associated signs or symptoms of a UTI, it’s important to talk to a healthcare provider to make sure that the bleeding isn’t due to a different cause. Rarely, blood in the urine (without any other symptoms) can be a sign of a more serious condition, such as bladder cancer.