Painful pee? The facts about UTIs

Updated November 16, 2018.

Urinary tract infection (UTI) is the general term for an infection occurring anywhere in the urinary system. Most UTIs involve the bladder and the urethra (the tube that drains the bladder), but some can also involve the ureters (the tubes that carry urine from the kidneys to the bladder), and even the kidneys themselves.

Urinary tract infections are virtually always caused when bacteria that are normally present on the skin or in GI tract make their way into the urinary system. UTIs are very common among women; about 50 to 60 percent of adult women have had at least one UTI. The numbers are significantly lower for adult men.

This frustrating fact has a simple anatomical explanation. In women, as compared to men, the bacteria that normally live in the pelvic region don’t have as far to travel in order to infect the bladder. Women have a much shorter urethra, and the urethra itself is much closer to the rectal opening—which is the most common source of bacteria in UTIs. This also explains why women often wake up with UTIs after intercourse. All that motion tends to push bacteria from the skin toward—and into—the urethra.

Symptoms of a urinary tract infection include:

• Pain or a burning when you urinate
• The urge to urinate more frequently, though you may produce very little urine each time
• Foul-smelling, cloudy, or bloody urine
• Pain in your lower abdomen, just above your bladder

When these symptoms are accompanied by fever, nausea or back pain, the UTI may have progressed to a kidney infection (also known as pyelonephritis).

If it’s your first UTI, please make an appointment with your primary care physician to determine the best treatment. If you’ve been treated for UTIs in the past and you’re a One Medical patient, you should call the office and ask to speak to someone who can help you determine your next steps. Depending on your individual case, we may be able to prescribe an antibiotic for you without requiring an office visit. You can also accomplish this by using the One Medical app.

Most urinary tract infections can be confirmed with a quick office-based urine test, but we may also send the urine specimen to a lab to identify the bacteria and to help select the best antibiotic to eradicate the infection. Occasionally sexually transmitted diseases like chlamydia or gonorrhea can cause symptoms similar to a UTI, so we sometimes test for those infections as well.

Almost all urinary tract infections can be treated very effectively with oral antibiotics. We’ll choose an antibiotic based on the type of bacteria you have (or are most likely to have). We’ll also consider factors like pregnancy, allergic reactions, other medications, and if certain antibiotics failed to work for you in the past. Be sure to tell your provider if you think any of these factors might be relevant!

Usually a three- or five-day course of antibiotics is sufficient, but if your kidneys are involved, we will give you at least a ten-day course. Severe cases might require intravenous antibiotics; this is very rare.

Pyridium is an optional medication that we can prescribe to relieve bladder pain, but it won’t shorten the duration of the infection. Only antibiotics will ultimately clear the infection and the pain associated with it.

• Stay well-hydrated by drinking plenty of water. This will increase the volume of your urine, which in turn helps flush bacteria away from your bladder and urethra.
• Be sure to take frequent bathroom breaks—even if you are having a busy day. Holding in your urine gives bacteria a chance to make themselves at home in your body.
• Urinate before and after having intercourse to help flush bacteria away from your urethra.
• Wipe from front to back after bowel movements.
• Diaphragms and spermicide can contribute to the development of UTIs in women. If you are using either of these birth control methods, you might want to discuss other options with your provider.

If these suggestions don’t work, or if you get UTIs more than three times a year, be sure to discuss your situation with your health care provider.

Some studies have indicated that drinking cranberry juice or taking cranberry tablets daily can help prevent UTIs, but will not treat the UTI once you have it. If you enjoy drinking cranberry juice and you feel that it helps you, there’s no harm in trying it (unless you are on a blood-thinning medication, in which case cranberry juice should be avoided).