Urinary Tract Infection

A urinary tract infection occurs when bacteria begin to grow in the urine. The infection usually starts at the opening of the urethra where the urine leaves the body and travels into the urinary tract.

For lower urinary tract infection (cystitis):

• Painful, burning and more frequent urination
• The sensation of not being able to hold in urine
• Feeling a need to urinate but only a few drops of urine come out
• Cloudy, bad-smelling or bloody urine
• Lower abdominal pain
• Mild fever (less than 101°F) and chills

For upper urinary tract infection (pyelonephritis):

• Fever (higher than 101°F)
• Shaking, chills
• Nausea and vomiting
• Pain in the back and side, at waist level

A urologist will perform a physical exam and one or more tests:

• Urinalysis: An examination of the composition of the patient’s urine.
• Urine Culture: A lab evaluation of the urine to determine what bacteria are causing the infection.

Patients with recurring UTIs may require image testing to detect underlying problems in the urinary tract:

• • MicroGen Dx: Molecular urine study to identify bacterial and fungal DNA by PCR and Next Generation Sequencing to identify infections that are unable to be detected by traditional urine cultures.
  • Cystoscopy: A slender tube with a tiny camera is inserted into the urethra to view any abnormalities in the urethra or bladder.
  • CT scan: A detailed picture of the urinary tract.
  • Ultrasound: An imaging of the kidney and bladder using a wand-like instrument that emits sound waves and picks up the echoes as they bounce off organs.

Antibiotics are usually prescribed. In more severe cases, hospitalization and IV antibiotics may be necessary. Issues requiring a hospital stay may include:

• Pregnancy
• Unresponsive to outpatient antibiotics
• Underlying diseases or medications compromising the immune system
• Inability to keep food down because of nausea or vomiting
• Kidney stones

Postmenopausal women may want to ask their doctors about using vaginal estrogen to prevent recurrent UTIs.

Click here for a quick reference guide for our approach to treating UTIs.