What you should know about urinary tract infections

A bowl of cranberries and a glass of cranberry juice
Urological health is often put to the wayside until something feels wrong. UChicago Medicine spoke with assistant professor of obstetrics and gynecology, Dianne Glass, MD, PhD, to debunk myths about urinary tract infections (UTIs) and discuss ways to prevent them.

What causes urinary tract infections and what are the symptoms?

Urinary tract infections (UTIs) are very common in sexually active young women as well as women after menopause. Urinary tract infections occur when bacteria from the vagina invade the bladder by climbing the urethra. In rare cases, the same bacteria can climb the ureter — the tube that connects the bladder and kidney — and cause a kidney infection.

The most common symptoms of a urinary tract infection are a burning sensation during urination, pelvic pain, frequent need to urinate, and the feeling of not being able to completely empty your bladder.

With severe urinary tract infections, a woman might see blood in her urine. In older patients, symptoms are sometimes more subtle and can include confusion.

What qualifies as a "recurrent UTI" and what causes them?

Patients who have had two urinary tract infections in the past six months or three in the past year have "recurrent" urinary tract infections. Patients who have recurrent urinary tract infections are often referred to a urogynecologist or a urologist for further evaluation, and may require treatment to prevent infections.

Risk factors for recurrent urinary tract infections can be divided into two categories: behavioral and genetic. Behavioral risk factors include sexual activity, a new sexual partner and the use of spermicides. Genetic and health-state risk factors include having a mother with a history of UTIs, having UTIs as a child, diabetes fecal incontinence, urinary incontinence and being post-menopausal.

Do symptoms differ for men and women?

Because of differences in anatomy, UTIs are far more frequent in women than men. Women make up 84 percent of medical visits for UTIs. Symptoms are similar between genders, but a UTI in a man often requires further evaluation by a specialist.

If UTIs go untreated, what can occur?

If left untreated, some bladder infections will go away on their own. The main concern with delaying treatment for UTIs is the discomfort that they cause. Generally, UTI symptoms improve within a few days after starting antibiotics. Prolonged bladder infections can lead to a period of bladder pain and urinary frequency after the infection has resolved. In rare cases, untreated bladder infections can lead to bacteria entering the ureters and cause infection within the kidneys.

How are UTIs treated?

Urinary tract infections are treated with a short course of antibiotics. Some of the bacteria that cause UTIs are resistant to some of these antibiotics so urine cultures are often done to confirm if the proper antibiotic is being used.

What are myths about at-home UTI treatments that can be debunked?

Popular at-home methods for treating or preventing UTIs include: increasing how often you urinate, wearing certain types of underwear, avoiding hot tubs and bubble baths, urinating after intercourse and wiping away from the urethra. Douching is not a recommended treatment for UTIs as it can cause additional issues for the reproductive system. There is no evidence to support the efficacy of these behaviors; however, there is little harm in using them.

Probiotics, cranberries, vitamin C and D-mannose are all supplements that have been studied for their potential to prevent urinary tract infections. There is a plausible mechanism for each of them; however, studies have not consistently shown marked benefit. More evidence is needed to make a final recommendation for or against their use or efficacy. Cranberry extract pills are more likely to be helpful than cranberry juice, since cranberry pills do not have the sugar that juice contains. Cranberry can contribute to heartburn and gastrointestinal upset.