Urinary tract infection

Overview

“Urinary tract infection” is a general umbrella term for a group of diseases that affect the urinary system. Depending on the cause and what part of the urinary tract is infected, different conditions with specific symptoms occur. The most common is bladder infection (urocystitis). The infection can also spread higher to the kidneys (pyelitis) or affect the urethra (common in sexually transmitted infections).

Symptoms

General symptoms

• Difficulty in passing urine, sometimes burning and pain during urination
• Frequent need to urinate (also during the night)
• Dribbling, small amounts of urine
• Urine may be cloudy, reddish brown (if it contains blood) and foul-smelling
• Uncontrolled urine leakage
• Dull, cramping pains in the bladder area

Complications

• Increasingly severe pain in the lower abdomen, back and sides
• Fever or chills
• Growing discomfort and nausea
• Chronification

Causes and treatment

Causes

Pathogens: 80% of all infections are caused by intestinal bacteria (Escherichia coli)

Risk factors:

• Female anatomy (urethra is shorter and located closer to the anus)
  • Bladder infections in men should always be investigated further
• Pregnancy
• Menopause
• Inappropriate hygiene measures after a bowel movement
• Unprotected sexual intercourse with an infected partner
• Medication (e.g. cortisone, antibiotics)
• Diabetes, enlarged prostate
• Diseases/anomalies of the urinary tract (e.g. bladder descent, urinary stones, urethral stricture, tumours)
• Foreign bodies (e.g. urinary catheter, intimate jewellery, sex toys)

Further treatment by your doctor / in hospital

Possible tests:

• Chemical and microscopic urine test
• Urine culture (search for bacteria)
• Blood test, if necessary
• Urethral swab, if necessary
• In particular for complex cases: ultrasound, bladder endoscopy

Possible therapies:

• Relieving of symptoms (e.g. pain treatment)
• Antibiotics
• Surgery for mechanical obstructions such as constrictions, urinary stones, tumours

What can I do myself?

Preventive measures:

• Avoid hypothermia
• Intimate hygiene: wipe from front to back, don’t use vaginal douches and vaginal deodorants
• Follow the safer sex rules:
  • Always use a condom or femidom during sexual intercourse
  • Don't get sperm or blood (including menstrual blood) in your mouth, and don’t swallow
• Urinate immediately after intercourse
• Make sure to completely empty the bladder
• Drink more fluids
  • Drink > 2 litres of unsweetened fluid per day
  • If a heart or kidney disease has been diagnosed, only after consultation with a doctor

When symptoms start, also:

• Cranberry extract or juice: supports the bladder mucosa and has an anti-inflammatory effect
• Heating pad or hot water bottle (to relax the bladder and pelvis)
• Common painkillers such as ibuprofen and paracetamol (read the package insert)

When to see a doctor?

• No noticeable improvement with household remedies within two days
• Itching, burning or discharge in the genital region
• Fever, back or flank pain in the area of the kidneys
• Urine is red or contains pus
• Generally for recurrent bladder infections

Synonyms

urinary tract infection, bacterial urinary tract infection, UTI