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Feb 21, 2023

Anatomy of the Urinary Tract

Your urinary system plays a major role in your health and wellness. It filters excess water and waste as urine. The urinary tract consists of two kidneys, two ureters, a bladder, and a urethra. These organs work together to filter, store, and remove liquid waste from the body as urine. A urinary tract infection (UTI) is a very common bacterial infection that occurs in any part of your urinary system. UTIs are more common in women than men due to the female anatomy. More than 60% of women will get a UTI at least once in their life and some more will go on to have recurrent infections. In the U.S., UTIs lead to about 8 to 10 million clinic visits per year , 1-3 million emergency room visits, and about 100,000 hospitalizations per year.

The different parts of the urinary tract function together to rid the body of waste and extra fluid through the process of urination. 





What Causes UTI?

UTIs are caused when bacteria, especially E. coli, enter your urinary tract through the urethra. E. coli lives harmlessly in the gut and anus, but if it travels from the anus to the urethra, it can multiply in the urinary tract and cause infections. Typically, bacteria that enters the urinary tract is flushed out when you urinate. This one-way flow keeps things clean and healthy. But things do not work out that way and these bacteria overgrow and accidentally get into the bladder or urethra, thus causing infections. Up to 95% of UTI is caused by E. coli found in stool in the rectum. In rare cases, a UTI can be caused by other types of bacteria or even fungi. 

There are different types of UTIs depending on what part of the urinary system is infected. 

  • Urethritis – infection in the urethra (the tube that carries urine from the bladder out of the body)
  • Pyelonephritis – infection in the kidney (also known as nephritis)
  • Cystitis – infection in the bladder (the organ that collects and stores urine)

Symptoms of Urinary Tract Infections

Urinary tract infections do not always have signs and symptoms, but when they do, the symptoms could vary based on location of the infection (bladder, urethra, or kidney). If the infection is within the bladder or urethra, the symptoms can include:

  • Strong, persistent urge to urinate often
  • Pain while urinating 
  • Burning while urinating 
  • Passing frequent small amounts of urine 
  • Fullness in bladder even after urinating 
  • Cloudy urine
  • Strong-smelling urine
  • Pelvic pain and pressure (in women)
  • Lower abdomen discomfort 
  • Fatigue or weakness 
  • Red, pink, or cola-colored urine when there is blood in your urine
  • Discharge 

If the infection has spread to the kidney, additional symptoms can include:

  • Pain in lower back or side
  • Fever and chills
  • Nausea and vomiting 

The signs and symptoms will depend on the part of the urinary tract affected. Infections in the kidney are most likely to cause fever and chills compared to infections in the urethra, which would mostly be burning with urination and sometimes vaginal discharge. Bladder infections can cause pelvic pressure and frequent urination. Contact your doctor if you have any of these signs and symptoms for proper diagnosis and treatment. 

Is UTI a Sexually Transmitted Infection (STI)?

You may wonder if a UTI is a sexually transmitted infection (STI) and if it is contagious. It is possible to pass the bacteria that causes UTI between partners, but urinary tract infections are not a sexually transmitted infection and are not considered contagious. Most times, the bacteria that causes UTI can pass from the anus to the vaginal opening and, during sex, can cause infections. In rare instances, UTI is a side effect of STIs like trichomoniasis and chlamydia, and in those circumstances, the STIs can pass between partners.  

How to Treat UTI

The first step to treating UTI is accurate diagnosis. Getting treatment right away can reduce the chances of complications such as kidney infection, a situation where the infection moves up to one or two kidneys. 

To determine the best treatment for you, your healthcare provider might have a urine sample analyzed in the laboratory. Your urine sample may also be cultured to see what sort of bacteria is causing your infection. If you have frequent UTIs, your healthcare provider might request for a scan of the pelvic area with or without a dye contrast to see if you have any abnormalities in the urinary tract. The doctor might examine your bladder and urethra using a long, thin lens called a cystoscope to look inside.

Some UTIs might resolve on their own, but UTIs are typically treated with antibiotics. The choice of drug will depend on how complicated and frequent the UTI is. Most UTIs are treated with common antibiotics such as nitrofurantoin (Macrobid), cephalexin (Keflex), and trimethoprim/sulfamethoxazole (Bactrim). Even though most UTI symptoms will resolve within the first few days of taking your medication, it is extremely important to complete the course of antibiotics to reduce reinfection. Sometimes your healthcare provider might add some pain killers to your regimen, especially if you have a burning sensation while urinating. More complicated UTIs might require intravenous antibiotics in the hospital. 

Things you can do to reduce the discomfort of UTI include avoiding drinks like coffee and juice, which can aggravate your symptoms, and use a warm heating pad on your stomach to reduce discomfort. 

How to prevent UTIs

Although UTIs are common, you can reduce the risk by keeping your urinary tract healthy. A few things you can do to reduce the chances of getting a new or recurrent UTI include:

  • Eating a healthy and balance diet
  • Emptying out the bladder frequently 
  • Emptying your bladder after sex 
  • Practicing clean and safe sex
  • Wiping from front to back after using the toilet to avoid spreading bacteria into the vagina
  • Changing pads and tampons often while on your period
  • Wearing loose-fitting bottoms to allow for air circulation and reduce risk of bacteria moving into the urinary opening 
  • Choosing cotton and breathable underwear over synthetic ones that can trap moisture 
  • Avoiding douching as it upsets the female flora
  • Choosing milder soaps and unscented feminine hygiene products over scented ones
  • Staying hydrated with water and fluids
  • Avoiding liquids that irritate the bladder like coffee, sugary drinks, and alcohol 
  • Drinking cranberry juice (avoid if you are taking blood-thinning medications)
  • Taking probiotics (restores and maintains natural balance of gut bacteria)

Even though some UTIs will resolve on their own if not treated with antibiotics, pregnant women or those experiencing UTI symptoms accompanied by pain near the back, vomiting, fever, and chills, should contact their healthcare provider immediately as these can be signs and symptoms of more acute problems.

When to call you doctor

You should consult with your doctor if you have new and worsening symptoms, including:

  • Unusual discharge and vaginal odor
  • Severe abdominal or back pain
  • Blood in your urine 
  • Persistent symptoms after completing a course of antibiotics 

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