Everything You Wanted to Know About UTIs

Let’s talk UTIs!

Urinary tract infections—chances are most of us have suffered from them at some point. They’re really common. If you have a vagina, even more so. Data suggests that in India, 33.54 per cent of the population gets infected by UTI, with women or people with vaginas more prone towards contracting it. We get into why that happens later. UTIs are among the most prevalent microbiological illnesses in humans.

In a study published in 2022 by the National Center for Biotechnology Information (USA), there were 404.61 million cases and 236,790 deaths related to UTIs recorded in 2019. It’s annoying and painful but mostly short-lived. But it can be a recurring infection. However, there are treatment options that are simple and many preventable methods, too. Certain lifestyle factors, such as diet and hygiene, may significantly impact the occurrence and prevention of urinary tract infections. It has been reported that climate change may be one of the risk factors for UTI infection. Have more questions? Look no further. 

Most UTIs are simple infections that are easily treatable. But there are complicated cases where the infection can cause sepsis (florid urosepsis), aka where your body causes an extreme reaction to the infection, and where, without intervention and timely treatment, it can cause organ failure, tissue damage and death. Many hospitals consider UTIs as the most common presenting causes of sepsis. As with all diseases, remember these are possible scenarios and not definite outcomes. Treatment and prevention are your trustworthy weapons in all these cases.

A urinary tract infection is a prevalent infection in the urinary system that occurs in the urethra, kidneys, and bladder. The infection develops when bacteria get into the urinary tract. These bacteria typically live in our large intestines and are present in faeces. They are the most common source of infection. Sexual intercourse may move the bacteria into the urinary tract. Catheters are another common source of infection. 

There are three types of UTIs among all genders, distinguished by which part of the urinary tract is infected:

• Urethritis is an infection of the urethra, the hollow tube that drains urine from the bladder to the outside of the body.
• Cystitis is a bacterial infection in the bladder that often has moved up from the urethra.
• Pyelonephritis is an infection of the kidneys that has spread up the tract, or from an obstruction in the urinary tract. 

UTIs are infections caused by bacteria. It’s important to remember that not all bacteria are bad and cause UTIs. Like many regions of our body, the bladder, too, has bacteria and other microorganisms that are needed for healthy functioning. However, the ‘bad bacteria’ (usually from the bowels) can travel into the urethra and subsequently the bladder and cause UTIs. As the US Department of Health notes, this can happen from not drinking enough fluids or holding in your pee for a prolonged time (thus building a hospitable environment for infections); some forms of birth control can increase the risk, as well as conditions that can block the flow of urine like a tumour, kidney stones or sexual intercourse.   

Some people are at higher risk of getting a UTI. UTIs are more common in females because their urethras are shorter and closer to the rectum. This makes it easier for bacteria to enter the urinary tract.

Other factors that can increase the risk of UTIs:

• A previous UTI
• Sexual activity
• Changes in the bacteria that live inside the vagina, or vaginal flora. For example, menopause or the use of spermicides can cause these bacterial changes.
• Pregnancy
• Age (older adults and young children are more likely to get UTIs)
• Structural problems in the urinary tract, such as enlarged prostate
• Poor hygiene, for example, in children who are potty-training

According to the Cleveland Clinic, symptoms can include the following: A burning sensation while peeing; a higher frequency or need to pee (regardless of how much fluids you’re drinking); that uncomfortable feeling after peeing that you still have to go; possible pain around the bladder or genitals. You can also have a low-grade fever and chills, your pee can look cloudy and smell strong, and people with a penis can experience pain there too. Seek medical intervention immediately because it’s all treatable and manageable.

Younger children may not be able to tell you about urinary tract infection symptoms they are having. While fever is the most common sign of UTI in infants and toddlers, most children with fever do not have a UTI. If you have concerns that your child may have a UTI, talk to a healthcare professional.

Women are more prone to UTIs than men. Why? Blame it on the anatomy—the shorter female urethra creates a direct path for bacteria, especially given its close proximity to the reproductive organs. Notably, the shorter length diminishes the barrier against bacterial intrusion. Women with repeated UTIs may have inherited genes that make them more likely to get these infections. 

Actually, yes. UTIs do increase in incidence after the menopause. During menopause, oestrogen levels drop, which can alter the microbiome in the vagina and bladder. Postmenopausal women are disproportionately affected by recurrent UTIs. However, the field of urobiome research for bladder health and disease is new and excited about discoveries on how to prevent and manage, and keen to come up with efficacious treatments.

There have been suggestions that “weakened and stretched pelvic muscles after childbirth, with ageing, or from genetic causes” can contribute towards UTI in women. Keep your pelvic muscles tight with regular Kegels.

Your healthcare professional will determine if you have a UTI by:

• Asking about symptoms
• Doing a physical exam
• Ordering urine tests, if needed

Bacteria cause UTIs, and there are specific medications to treat them. However, any time you take medications for this, they may cause side effects. Side effects can include rash, dizziness, nausea, diarrhoea, and yeast infections. Call your healthcare professional if you develop any side effects while taking your antibiotic.

Sometimes, other illnesses, such as sexually transmitted diseases, have symptoms similar to UTIs. Your healthcare professional can determine if a UTI or different illness is causing your symptoms and determine the best treatment.

Drink plenty of water or other fluids. Your healthcare professional might also recommend medicine to help lessen the pain or discomfort. Always talk with your healthcare professional if you have any questions about your antibiotics.

• Hydration hero: Drink plenty of water daily to flush out bacteria. It's critical to maintain proper hydration to avoid UTIs. Toxins and bacteria are removed from the urinary system with adequate water consumption. Drink more fluids whenever you sweat or exercise. 
• Wipe it right: To stop germs from getting into your urethra, always wipe from front to back after using the restroom.
• Don’t hold it: Pee when you've got to go go. Holding it in can give bacteria more time to party.
• The post-sex pee: Pee after sex to help wash away any bacteria that might have snuck in.
• Cotton is king: Tight clothes and undergarments can trap moisture and serve as a haven for bacteria. If you feel you’re more prone to UTIs, try to choose breathable, loose-weave materials like cotton to encourage airflow. 
• Cranberry power: Studies suggest cranberry juice might help, suggesting that the compounds found in cranberries may help prevent bacteria from attaching to urinary tract walls. But don't ditch the doctor.

Medically reviewed by:

Dr Shilpy Lakhtakia, Obstetrician and Gynaecologist