Urinary tract infections (UTI) are among the most common infections in humans; and women and people with vaginas are at greater risk of developing a UTI. They are mainly caused by bacteria; however, some are caused by fungi and in rare cases by viruses.
Your urinary tract is made up of your: kidneys, ureters, bladder, urethra. Most UTIs only involve the urethra and bladder, in the lower tract. In rare and more severe cases, the infection can reach the upper tract and involve the ureters and kidneys.
Urinary tract infections don’t always cause signs and symptoms, but when they do, it is important to be able to distinguish between a lower or upper tract infection.
Lower tract UTI symptoms
Lower tract UTIs affect the urethra and bladder. Symptoms of a lower tract UTI include:
- Βurning with urination
- Ιncreased frequency of urination without passing much urine
- Ιncreased urgency of urination
- Βloody urine
- Cloudy urine
- Urine that has a strong odor
- Pelvic pain in people with a female reproductive system
- Rectal pain in people with a male reproductive system
- Upper tract UTI symptoms
Upper tract UTI symptoms
Upper tract UTIs affect the kidneys. These can be potentially life threatening if bacteria move from the infected kidney into the blood. This condition, called urosepsis, can cause dangerously low blood pressure, shock, and death.
Symptoms of an upper tract UTI include:
- Pain and tenderness in the upper back and sides
Each type of UTI may result in more-specific signs and symptoms, depending on which part of your urinary tract is infected.
Part of urinary tract affected Symptoms
Kidneys (acute pyelonephritis) Back pain or side (flank) pain, high fever, shaking and chills, nausea, vomiting
Bladder (cystitis) Pelvic pressure, lower abdomen discomfort, frequent and painful urination, blood in urine
Urethra (urethritis) Burning with urination, discharge
UTI risk factors
- Age (Older adults are more likely to get UTIs.)
- Reduced mobility after surgery or prolonged bed rest
- Kidney stones
- A previous UTI
- Urinary tract obstructions or blockages, such as: enlarged prostate, kidney stones, certain forms of cancer
- Prolonged use of urinary catheters, which may make it easier for bacteria to get into your bladder
- Abnormally developed urinary structures from birth
- Weakened immune system
Risk factors specific to women and people with vaginas include:
In female bodies, the urethra is very close to both the vagina and the anus. This increases the likelihood of developing UTIs. Bacteria that may naturally occur around both the vagina and anus can lead to infection in the urethra and the rest of the urinary tract. Urethras in women are also shorter, and the bacteria have a shorter distance to travel to enter the bladder.
Pressure on the female urinary tract during penetrative sex can move bacteria from around the anus into the bladder. Oral sex can also introduce bacteria into the urethra, increasing the risk of infection. Peeing after sex may help reduce the risk of infection.
Spermicides are a kind of birth control that has chemicals that stop sperm from reaching an egg. You put it in your vagina before sex to prevent pregnancy. This can increase UTI risk, because they can disrupt the vaginal microbiome.
Condom use during sex
Non-lubricated latex condoms may increase friction and irritate the skin during sexual intercourse. This may increase the risk of a UTI. However, there are many reasons to use condoms. They’re important for reducing the spread of sexually transmitted infections (STIs) and preventing unwanted pregnancy. To help prevent friction and skin irritation from condoms, be sure to use enough water-based lubricant during sex. Avoid using condoms that have been coated with spermicide.
Decrease in estrogen levels
After menopause, a decrease in estrogen level changes the normal bacteria in your vagina. This can increase the risk for a UTI.
If you suspect that you have a UTI, you will need to have a lab test of a sample of your urine; this test is called urinalysis.
At omgyno you can order a home test and take your own sample to be sent to the lab and diagnosed. You can find the vaginal culture and urinalysis test to identify the cause of any infection you may have as well as the type of antibiotics that will work in your body in case you have a UTI.
When is the best time to collect?
It is not necessary to take your sample first thing in the morning but if possible, collect the sample when urine has been in your bladder for 2 to 3 hours.
To ensure accurate lab results it is best to follow these steps carefully to prevent germs from the vagina from getting into urine sample.
- Wash your hands with soap and warm water.
- Wash your vulva, especially between the labia, also with warm water and soap.
- Sit on the toilet with your legs spread apart.
- Use two fingers to spread open your labia (vaginal lips).
- Keeping your labia spread open, urinate a small amount into the toilet, then stop the flow of urine.
- Hold the urine cup a few centimeters from your urethra and urinate until the cup is about half full.
- Finish urinating into the toilet bowl.Please take your urine sample after you have booked your pickup with the courier. The sample should reach the lab within 24 hours, so it is best to take your sample the same day as the courier pickup.
The urinalysis lab results will give you a detailed overview of your urine which will indicate if you have a urinary tract infection.
You will be informed about the physical characteristics of your urine like color, pH, specific gravity, and reducing substances. You will also be informed about which chemical characteristics (Protein,Glucose, Ketones…) exist.
Through the microscopic examination you will be able to know the amount of white blood cells, red blood cells, epithelial cells, mucus, casts, crystals, amorphous sediment and microorganisms.
The urine culture will show if you have any of the following infections: Candida Albicans, E. coli, Proteus Mirabilis, Pseudomonas spp., Klebsiella spp., Staphylococcus spp., Enterococcus spp., Streptococcus spp.
Through the antibiogram you will learn about the resistance of bacteria to certain antibiotics. This test is done when infection has been detected in the aerobic culture. The results can be:
Sensitive: Your body is sensitive to the following antibiotics. These medications can eliminate the infection.
Semi Sensitive: Your body is semi sensitive to the following antibiotics. These medications might or might not eliminate the infection.
Resistant: Your body is resistant to the following antibiotics. These medications cannot eliminate the infection.
You can take these steps to reduce your risk of urinary tract infections:
- Drink plenty of liquids, especially water. Drinking water helps dilute your urine and ensures that you’ll urinate more frequently — allowing bacteria to be flushed from your urinary tract before an infection can begin.
- Wipe from front to back. Doing so after urinating and after a bowel movement helps prevent bacteria in the anal region from spreading to the vagina and urethra.
- Empty your bladder soon after intercourse. Also, drink a full glass of water to help flush bacteria.
- Avoid potentially irritating feminine products. Using deodorant sprays or other feminine products, such as douches and powders, in the genital area can irritate the urethra.
- Change your birth control method. Diaphragms, or unlubricated or spermicide-treated condoms, can all contribute to bacterial growth.
If you experience UTI symptoms, do not neglect them as they may lead to a more severe infection. Take the vaginal culture and urinalysis test and you will receive your results within 3-5 days via email.
If your results are positive and you do have a UTI, you may book a telehealth session with one of our gynecologists in order to get a medical consultation and an antibiotics prescription for treatment.
Note: references to “male” and “female” or “women” and “men” in this article refer to sex assigned at birth, not gender.