Urinary Tract Infection (UTI)

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Abnormal urinary symptoms, such as a burning sensation during urination, increased urination frequency, or cloudy/strong-smelling urine could indicate a urinary tract infection (UTI), which is quite common especially among women and the elderly. If you recognise any of these symptoms, consult a doctor for a proper evaluation and prompt treatment plan.

Medically reviewed by Dr Michael Wong, Medical Director & Senior Consultant Urologist

FAMS (Urology), FICS (USA), FRCS (Edinburgh), M Med (Surgery), MBBS (S’pore)

Woman experiencing bladder pain due to a urinary tract infection (UTI)

What Is aUrinary Tract Infection (UTI)?

Urinary tract infection (UTI) refers to an infection affecting the bladder, urethra, ureter and kidneys. Affecting more women than men and children, UTI is often caused by microbes such as bacteria and, in rare cases, viruses and fungi. UTI is a very common medical complaint that is easily treatable using antibiotics. However, left untreated, it can lead to kidney impairments, pregnancy complications, and even sepsis.

Different Types ofUrinary Tract Infection (UTI)

UTI may be classified into different types based on which part of the urinary tract is infected.

Cystitis

This is an infection of the bladder and is the most common type of UTI.

Urethritis

This is an infection of the urethra caused by bacteria from the gastrointestinal tract as well as sexually transmitted infections (STIs).

Pyelonephritis

This is an infection of one or both kidneys that has spread up from the tract; it is the most serious type of UTI as it can cause serious health problems.

Woman holding a tissue, suffering from a urinary tract infection (UTI)

What Are the Signs and Symptoms of a UTI?

UTI symptoms can differ based on age and the type of infection, and some people may not experience any symptoms at all. Common symptoms of a UTI include:

Dysuria, or burning or painful urination

Abdominal, loin, back or flank pain

Urinary urgency and frequency

Bladder fullness or pressure

Haematuria, or blood in urine

Painful sexual intercourse

Cloudy or milky urine

Foul-smelling urine

What Causes UTI?

The most common cause of urinary tract infections is the entry of microorganisms, especially bacteria, into the urinary tract. Most UTI cases are caused by E. coli bacteria. If this bacterium is carried from the rectum to the vagina, it can enter the urethra, multiply and infect the bladder. The infection can also travel up from the bladder through the ureters and eventually infect the kidneys.

While E. coli is the usual culprit, UTIs can also be caused by sexually transmitted microorganisms like chlamydia and mycoplasma. These infections typically affect only the urethra and genital area. Because they are spread through sexual contact, treatment for both partners is crucial to prevent re-infection.

What Are the Risk Factors for UTI?

Certain factors can also increase one’s risk of developing a UTI. These include:

Age

The elderly are more prone to UTIs because they are more susceptible to incontinence and urinary retention, which lead to infections.

Gender

In the female anatomy, the urethra is shorter and closer to the anus, which means the distance that bacteria will travel to infiltrate the bladder is also shorter.

Sexual Intercourse

Having frequent sexual intercourse and multiple sex partners increases the risk of coming into contact with bacteria that leads to bladder infections. Those who use birth control methods such as diaphragms and spermicides are also at a higher risk.

Urinary Tract Obstruction

Anything that blocks the flow of urine, such as kidney stones or an enlarged prostate, can lead to UTIs.

Urinary Tract Abnormalities

Congenital, structural or sustained abnormalities in the urinary tract increase one’s susceptibility to infections.

Suppressed Immune System

Illnesses that weaken the immune system disable the body’s ability to fight off infections such as UTIs.

Recent Urinary Surgery

Open procedures or exams that involve the insertion of medical instruments expose the urinary tract to bacteria.

How Is A UTI Diagnosed?

A urinalysis is the primary test performed to diagnose a urinary tract infection as well as kidney problems. This laboratory test, which only involves a urine sample, checks the content, appearance and concentration of urine for any abnormalities. A urine culture may also be done to detect bacteria or yeast that are causing the infection.

How Is Urinary Tract Infection (UTI) Treated?

The strategy for the treatment of a UTI is to address the bacterial infection with antibiotics prescribed by your urologist, remove the cause of the UTI, and prevent its recurrence. Antibiotics are the first-line treatment to address a urinary tract infection. The type of drugs prescribed and the duration of intake depend on the kind of bacteria present in the urine, the severity of the UTI and recurrence (if applicable).

The most common antibiotics used to treat UTIs are:

Amoxicillin

Cephalosporins

Ceftriaxone

Doxycycline

Cephalexin

Fosfomycin

Typically, simple infections go away a few days after treatment starts. In more severe cases, particularly those that already affect the kidneys, they will require a longer course of treatment. Surgery is usually not required to treat UTIs unless it is necessary to address blockages and urinary defects that increase one’s risk of developing the condition and subsequent recurrence.

What Is Recurrent Urinary Tract Infection?

A recurrent urinary tract infection is defined as the occurrence of two or more acute UTIs within months or three or more UTI episodes in a year. While good hygiene is important, recurrent UTIs are not caused by a lack of it and may sometimes be due to anatomical or biological factors beyond the patient’s control.

These recurrent infections can involve the same bacteria or different strains, and further evaluation may be needed to identify underlying causes.

How To Prevent UTI

Several measures can help prevent UTI. These include the following:

Drink plenty
of water

about 2 to 3 litres every day to flush out bacteria from your urinary tract.

Urinate when you feel the urge

and empty the bladder fully to prevent bacterial growth in the bladder.

Wipe your bowels from front to back

to avoid faecal contamination of the urinary tract.

Shower and urinate after sex

to flush out any bacteria that may have been introduced.

When Should I See a Doctor?

In some cases, urinary tract infections (UTIs) may resolve on their own, particularly those that do not present any symptoms. However, if you experience symptoms, it is necessary to see a doctor for a proper diagnosis and treatment.

Whether you are experiencing symptoms for the first time or dealing with recurrent infections, our team can provide a comprehensive diagnosis and personalised treatment plans. For more information on UTIs and their treatment methods, contact experienced urologist Dr Michael Wong at +65 6838 1212 today.

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