Urinary tract infection

What is a urinary tract infection?

The urinary system is composed of the kidneys (responsible for producing urine), ureters (which carry urine from the kidneys to the bladder), the bladder (where urine is stored), and the urethra (the “channel” through which urine exits the bladder and leaves the body).

A urinary tract infection (UTI) is a medical condition caused by bacteria, viruses, fungi, or other microorganisms that enter the urinary system, multiply within it, and cause changes such as inflammation.

Symptoms

The main symptoms of a urinary tract infection include:

• increased urinary frequency
• discomfort or burning sensation when urinating
• change in urine odor
• urinary incontinence, when urine is released unintentionally or without conscious control due to lack of self-regulation
• pelvic pain, with hypersensitivity and pain in the pelvic region and even the abdomen
• change in urine color, which may become darker or show traces of blood, either persistently or increasingly over time

Causes

Urinary tract infections (UTIs) have various causes, with the presence of bacteria in the urinary system being the most common. UTIs are more frequent in women due to the shorter length of the urethra. In men, UTIs are generally associated with conditions that impair bladder emptying and urinary function.

The mere presence of a germ in the urine does not necessarily indicate an infection. Certain situations and conditions may contribute to the development of a UTI, such as:

• obstructions: kidney stones or prostate enlargement in men, for example, can hinder urine flow and allow bacteria to accumulate and cause infection
• sexual activity: sexual intercourse can introduce bacteria into the urethra, increasing the risk of UTIs, especially in women
• menopause: the decrease in female sex hormones during menopause can make the urinary system more vulnerable to infections. Hormonal deficiency may alter the natural vaginal microbiota (bacteria, viruses, fungi, and other unicellular microorganisms that inhabit our bodies), facilitating bacterial growth and infection
• pregnancy: hormonal changes and bladder compression during pregnancy can increase the risk of UTIs

Diagnosis

UTI diagnosis is made by a healthcare professional based on a combination of symptoms, clinical exams, and laboratory tests. A targeted physical exam is usually performed to check for signs of urethral or vaginal discharge and assess possible complications.

Urinalysis and urine culture (to identify the presence of bacteria in the urinary system) are important to confirm the diagnosis and guide treatment. In addition to diagnosing the infection, it is essential to investigate any underlying cause.

Treatment

UTI treatment involves the use of antibiotics or antifungal medications (used for diseases caused by fungi). Generally, treatment begins empirically with antibiotics that are commonly effective against community-acquired bacteria.

Urine culture and sensitivity testing should always be reviewed to determine whether treatment strategy adjustments are needed. Increasing water intake to the amount recommended by a healthcare professional is important to help dilute urine and flush out bacteria. In severe cases, especially those affecting the kidneys, hospitalization may be necessary.

It is essential to seek medical attention when a UTI is suspected, as proper treatment is important to prevent complications and ensure resolution.

Whenever possible, a follow-up urine culture is recommended to confirm that the infection has been fully treated.

Prevention

Preventing UTIs involves adopting measures and habits that help reduce the risk of developing the condition, such as:

• maintaining good personal hygiene: wipe the genital area from front to back after using the bathroom
• drinking an adequate amount of water throughout the day: hydration helps dilute urine and prevent bacterial growth in the urinary system
• completely emptying the bladder: when urinating, ensure no residual urine remains, as this can promote bacterial growth
• urinating after sex: helps flush out bacteria that may have entered the urethra during sexual activity

By Einstein Editorial Board