A urinary tract infection (UTI) occurs when bacteria enter the urinary system, typically affecting the bladder or urethra. While many infections are mild and easily treated, recurrent or complicated UTIs can indicate underlying urologic issues that require specialized care. Prompt diagnosis and management are essential to prevent the spread of infection to the kidneys and avoid long-term damage.
Causes of Urinary Tract Infections
UTIs develop when bacteria—most commonly Escherichia coli (E. coli)—travel up the urethra into the bladder or kidneys. Contributing factors include:
- Incomplete Bladder Emptying: Often due to conditions like benign prostatic hyperplasia (BPH) or urethral strictures.
- Urinary Obstruction: From kidney stones, bladder stones, or tumors.
- Anatomical Abnormalities: Such as vesicoureteral reflux or ureteral strictures.
- Catheter Use: Indwelling catheters increase infection risk.
- Weakened Immune System: Due to diabetes, cancer treatments, or other chronic illnesses.
- Frequent Sexual Activity: Increases the likelihood of bacterial introduction.
Symptoms of a UTI
Symptoms vary depending on the infection site and severity:
- Burning or pain during urination
- Frequent or urgent need to urinate
- Cloudy, strong-smelling, or bloody urine
- Pelvic or lower abdominal discomfort
- Flank pain or fever (if infection reaches kidneys)
- In men, testicular pain or swelling may occur in more advanced infections
Diagnosis
A urologist will assess your symptoms and perform tests to confirm the infection and rule out structural or functional causes:
- Urinalysis and Urine Culture: To detect bacteria, white blood cells, and blood in the urine.
- Imaging (Ultrasound or CT Scan): To identify obstructions, stones, or anatomical abnormalities.
- Cystoscopy: May be recommended for patients with recurrent or complex infections.
- Post-Void Residual Measurement: To evaluate bladder emptying efficiency.
Treatment Options
Treatment depends on the severity of the infection and any underlying contributing factors:
- Antibiotics: Oral or intravenous, depending on the extent of infection.
- Stone or Obstruction Removal: Procedures such as ureteroscopy, lithotripsy, or stent placement may be necessary if a physical blockage is present.
- Bladder Management: For patients with poor bladder emptying or neurogenic bladder.
- Preventive Measures: Low-dose antibiotics or behavioral strategies for those with recurrent infections.
- Prostate or Urethral Interventions: In men with contributing BPH or strictures.
Next Steps
If you experience recurrent UTIs, severe symptoms, or infections that don’t resolve with antibiotics, a full urologic evaluation is recommended. Addressing the root cause—whether an obstruction, stone, or functional issue—can reduce the frequency of infections and protect long-term urinary tract health.