A urinary tract infection is an inflammation of the urinary tract, such as the urethra, bladder, or ureter. Bacteria usually cause the infection. Pain or burning when urinating and a strong and frequent urge to urinate are typical symptoms. Find out everything about other symptoms and treatment of urinary tract infections here.
- Symptoms: pain and burning when urinating, frequent urge to urinate, feeling sick, with more complicated courses: fever, chills, flank pain (inflammation of the kidney pelvis)
- Treatment: Depending on the cause, general: drinking a lot, frequent urination, rest; otherwise usually antibiotics
- Causes and risk factors: Mostly infection by intestinal bacteria due to the proximity to the anal region, female anatomy of the short urethra, risk factors including: immune deficiency, pregnancy, metabolic diseases, obstructions to drainage
- Diagnosis: Based on the symptoms, urine and blood tests, ultrasound examination (sonography)
- Course of the disease and prognosis: Good prognosis for uncomplicated urinary tract infections, usually complete recovery with antibiotics
- Prevention: General measures such as: drinking a lot, emptying the bladder regularly, healthy eating; Drug prevention, immune therapy and vaccination for recurrent urinary tract infections are possible.
What is a urinary tract infection?
A urinary tract infection or urinary tract infection (UTI) is usually an inflammation of the urinary tract caused by bacteria. The urinary tract includes organs that affect urine, such as the urethra, urinary bladder, or ureters. The pathogens usually migrate from the bottom up, i.e. from the urethra towards the bladder.
Typical symptoms of urinary tract infection are new pain when urinating, such as burning, and a frequent and strong urge to urinate.
Due to the short urethra, women in particular suffer from a urinary tract infection. It is the most common reason for disability among women. More than half of women suffer from a urinary tract infection at least once in their lives. The older women are, the more common UTIs occur. Men usually only become ill from an older age, when age-related urinary drainage disorders occur.
Classification of urinary tract infections
Doctors distinguish urinary tract infections according to different aspects:
- Where is the infection? In the upper urinary tract (inflammation of the renal pelvis) or in the lower urinary tract (urethra, bladder, prostate)?
- Does the infection cause symptoms ? Is there a symptomatic UTI or a so-called asymptomatic bacteriuria (pathogens are present in the urinary tract but do not cause symptoms)?
- Are there certain risk factors such as narrowing of the urethra, pregnancy or an immune deficiency that cause a complicated urinary tract infection or not (uncomplicated UTI)?
The distinction between complicated and uncomplicated urinary tract infections is important because complicated urinary tract infections are usually more serious (risk of so-called urosepsis) and/or more protracted. He is also treated differently.
What are the symptoms?
UTIs, like most bacterial infections, cause tissue redness and swelling.
Typical urinary tract infection symptoms are pain and burning when urinating, blood in the urine and a general feeling of illness. In severe cases, the urinary tract infection is sometimes accompanied by fever and chills. If the infection rises to the renal pelvis, flank pain is a typical sign of the disease.
Many of those affected, who repeatedly suffer from urinary tract infections, recognize the first signs of a urinary tract infection early on and can use home remedies to avert the impending cystitis.
Home remedies have their limits. If the symptoms persist over a longer period of time, do not get better or even get worse, you should always consult a doctor.
The urinary tract infection therapy depends on the cause. Depending on the degree of severity and the body’s immune system, a urinary tract infection sometimes even heals on its own. If the body’s immune system does not manage to fight the pathogens in the urinary tract, a doctor’s visit is imperative. This is the only way to prevent ascending infections and serious courses.
Doctors usually follow so-called guidelines in their therapy. These are expert group treatment recommendations for a specific condition based on current scientific knowledge.
Your doctor will ensure that the urinary tract infection is treated appropriately. He usually prescribes medication (antibiosis) and general measures that are important for a urinary tract infection. These include:
- Drink plenty of fluids (at least two liters a day) to flush out the urinary tract
- Empty the bladder regularly and frequently
- Heat applications, for example in the form of hot water bottles
- Bed rest if there is an infection of the renal pelvis.
If you suffer from heart failure, it is important that you clarify the daily amount of fluid with your doctor. For some people with heart failure, there is a drinking limit.
Which antibiotic the doctor uses depends on:
- Whether there are symptoms
- Whether it is a complicated or uncomplicated urinary tract infection,
- Where exactly is the inflammation and
- What its severity is.
In the case of an uncomplicated urinary tract infection, he usually prescribes short-acting antibiotics for one to three days, which bring about reliable healing very quickly.
If there are no symptoms such as pain from the urinary tract infection despite proven pathogens, treatment with antibiotics is not absolutely necessary in most cases. Exceptions are pregnant women and people who are about to have surgery on the urinary tract or if there is a risk that the infection will spread due to the urinary tract infection.
If there is a complicated urinary tract infection, doctors also prescribe antibiotics. As a rule, however, the therapy takes longer here, and other antibiotics are usually also used. In pregnant women and children, for example, doctors only use certain antibiotics that are more tolerable for these groups of people to treat a urinary tract infection.
What causes a urinary tract infection?
In most cases, intestinal bacteria trigger a urinary tract infection. In the case of uncomplicated urinary tract infections, the pathogen Escherichia coli comes first, but other residents of the intestinal flora such as Proteus mirabilis or Klebsiella pneumoniae are sometimes behind it.
The intestinal bacteria get from the anus into the outer urethra and then rise in the urinary tract and genitals (urogenital tract). Poor hygiene after going to the toilet is often responsible for this. In other cases, urinary tract infections occur after unprotected sex.
Women in particular are much more likely to suffer from a urinary tract infection. This is because women have a shorter urethra than men and the entrance to the urethra is closer to the anus. For this reason, germs can get into the bladder more easily. Young women in particular are often affected by a urinary tract infection.
Older people with a urinary catheter are also more likely to develop a urinary tract infection. Here, the bacteria use the catheter like a “guide rail”. Babies and children are also affected by a urinary tract infection. Especially when you are in diapers, as bacteria can easily and rapidly multiply in a damp environment.
Urinary tract infection – special risk factors
There are also certain factors that increase the risk of a urinary tract infection. These include:
- Immune deficiency, for example due to serious illnesses or medication such as immunosuppressants
- Metabolic diseases such as diabetes mellitus
- Urinary outflow disorders, for example due to urinary stones, tumors or an enlarged prostate
- Impaired function of the urinary bladder, for example in the case of paraplegia
Are urinary tract infections contagious?
In principle, it is possible that bacterial inflammation of the urinary tract is contagious. Especially when they occur in the lower urinary tract such as the urethra.
In most cases, however, the infection occurs by spreading the body’s own intestinal bacteria. For example, transmission during sex is also possible and not tied to gender. In some cases, men also become infected during sexual intercourse, but this happens much less frequently than in women due to the longer urethra.
How is a urinary tract infection diagnosed?
It is usually possible for the doctor to diagnose a “urinary tract infection” based on the typical symptoms and using a urine test strip. The test strip determines various typical changes in the urine such as the content of parts of red and white blood cells or certain products of bacterial metabolism (nitrate).
In many cases of urinary tract infection, the urine test strip shows a positive nitrite test. However, a negative nitrite test is not enough to rule out the disease. There are some bacteria that do not form nitrites.
Especially in the case of complicated or frequently recurring urinary tract infections (recurrent urinary tract infections), doctors have further examinations of the urine and blood carried out. With so-called urine cultures, the bacteria responsible for the urinary tract infection can be identified and tested for their sensitivity to antibiotic treatment.
The blood usually shows elevated levels of inflammation such as an increase in C-reactive protein (CRP), blood sedimentation and white blood cells (leukocytosis). If there is a fever, doctors sometimes do a blood culture to identify the pathogen.
In some cases, doctors also carry out an ultrasound examination (sonography) to determine any obstructions to the flow of urine. Other imaging procedures such as computed tomography or X-ray examinations with contrast media are rarely necessary.
What is a urinary tract infection like?
A urinary tract infection usually heals completely with antibiotics, and the prognosis is good.
The kidneys are usually not damaged either. However, it is important that you consult a doctor if you suspect a urinary tract infection in order to avoid complications. In some cases, especially if left untreated, an ascending urinary tract infection develops, resulting in inflammation of the renal pelvis.
The risk of a severe course and thus of urosepsis, i.e. blood poisoning that begins with an infection of the urinary tract, is low under medical treatment. Urosepsis is a medical emergency that can be fatal.
Even with recurring, i.e. chronic, urinary tract infections, the risk of chronic inflammation of the renal pelvis and damage to the kidney tissue (chronic pyelonephritis) is low. However, if there are certain risk factors such as narrowing of the urinary tract, the risk increases again.
Can a urinary tract infection be prevented?
There are a few things that can help prevent UTIs in some cases. These include:
- Sufficient fluid intake (flushes out any bacteria that may be present with the urine)
- Regular urination (counters to the growth of bacteria)
- Healthy diet with lots of vitamin C and ascorbic acid
- Urinating before and after intercourse
- Toilet hygiene is particularly important for women (wiping direction from front to back)
- Avoid cooling down (change wet laundry).
If urinary tract infections occur again and again, especially in women, there are medicinal options for prevention. Doctors sometimes prescribe antibiotics for a long time (several months), especially for complicated UTIs. In older postmenopausal women, an estrogen vaginal ointment often helps to reduce recurring UTIs.
Doctors define chronic or recurrent urinary tract infections as more than two urinary tract infections in six months or more than three urinary tract infections per year.
In addition, there are tablets for immune therapy and a vaccination to prevent recurrent urinary tract infections. Taking other preparations such as D-Mannose is also suitable, among other things, for the therapy of recurring urinary tract infections. It is best to discuss the right (medicinal) prevention with your family doctor, urologist or gynaecologist.