Urinary Tract Infection
What Is a Urinary Tract Infection (UTI)?
A urinary tract infection (UTI) can affect the kidneys, ureters, bladder or urethra. Bladder infection (cystitis) is the most common type. Most UTIs are caused by bacteria found in the intestinal flora, particularly Escherichia coli. Bacteria usually travel through the urethra into the bladder.
In women, the urethra is shorter and closer to the anus, which can make it easier for bacteria to reach the bladder. Sexual activity, pregnancy, menopause, urine remaining in the bladder, urinary stones or catheter use can also affect the risk. Although sexual activity can increase the risk of a UTI, a UTI is not a sexually transmitted infection. Since UTI symptoms can resemble those of some sexually transmitted infections, these infections should also be considered when necessary.
What Are the Symptoms of a Urinary Tract Infection?
A bladder infection may cause the following symptoms:
- Burning or pain when urinating
- Frequent urination or a sudden urge to urinate
- A persistent urge to urinate even when the bladder is empty
- Pressure or pain in the groin or lower abdomen
- Blood in the urine
Cloudy or dark urine alone does not establish a diagnosis of a UTI. Symptoms may have other causes; assessment is based on the symptoms and any necessary tests.
If the infection reaches the kidneys, fever, chills, flank or back pain, nausea and vomiting may occur. These symptoms may indicate a kidney infection and should be assessed promptly at a healthcare facility.
Urinalysis and Urine Culture for Diagnosis
Diagnosis is based on the person's symptoms and a doctor's assessment. In some typical cases of uncomplicated cystitis, clinical assessment may be sufficient; not everyone needs a urine culture. However, when a kidney infection is suspected, during pregnancy, in men, in recurrent or atypical infections, and when there is no response to treatment, urine culture and antibiotic susceptibility testing, together with urinalysis, are important.
A urine culture helps identify the bacteria growing in the sample and assess which antibiotics they are susceptible to. If possible, the sample should be collected before antibiotics are started; however, if urgent assessment or treatment is needed, sample collection should not delay treatment. A midstream urine sample should be collected in a clean container and delivered to the laboratory within the appropriate time frame.
What Does Recurrent UTI Mean?
When a UTI occurs several times a year, the term recurrent UTI is generally used rather than “chronic infection”. A commonly used definition is at least 2 episodes of infection within 6 months or at least 3 within 12 months. In recurrent cases, episodes should be confirmed by urine culture where possible, and underlying risk factors should be assessed by a doctor. Not everyone requires extensive imaging or other investigations.
Treatment and Antibiotic Use
Treatment is selected by a doctor based on the site of infection, the severity of symptoms, the person's health status and, when necessary, the culture and antibiotic susceptibility results. Culture and antibiotic susceptibility testing are recommended for kidney infections; the choice of treatment should be consistent with local antibiotic resistance patterns and the test results.
Antibiotics should not be taken on someone else's recommendation, from medication left over from a previous prescription, or simply because bacteria are found on urinalysis. The presence of bacteria in the urine without symptoms does not require antibiotic treatment in most people; important exceptions include pregnancy and situations before certain urological procedures.
When Should You Seek Medical Care?
If you have symptoms such as burning when urinating, frequent urination or lower abdominal pain, consult a healthcare professional for assessment. Seek medical help promptly if you have fever, chills, flank or back pain, nausea or vomiting, rapid worsening of symptoms or a deterioration in your general condition. Symptoms should be assessed earlier during pregnancy, in children, in men, in people with weakened immune systems or in those with significant coexisting medical conditions.
Reducing the Risk of UTIs
- Drink enough fluids throughout the day; fluid requirements may vary depending on the person and their health status.
- Try not to delay urinating for long periods.
- Make a habit of wiping from front to back after using the toilet. However, UTIs cannot be attributed solely to “poor hygiene”; anatomy and other risk factors also play a role.
- Avoid vaginal douching or using irritating scented products in the genital area.
- If you have frequently recurring UTIs, discuss prevention options with your doctor. Increased fluid intake may benefit some women with recurrent cystitis, particularly those who usually drink little fluid.
You can visit our Nicosia or Kyrenia branches for urine sample collection and culture.