Urinary Tract Infections (UTIs):Diagnosis,Treatment and Prevention

Updated: June 16, 2022

Urinary tract infections are caused by microbes such as bacteria which can can affect any part of the urinary system which can be the kidneys, ureters, bladder, or urethra .

Diagnosis of UTIs:

Diagnosis can be done by asking about the symptoms and testing a urine sample to assess the presence of white blood cells, red blood cells and bacteria.
If a person has recurrent UTIs, further diagnostic test such as CT and MRI scanning can be done to determine the presence of any anatomical issues or functional issues.
Such tests may include:

Diagnostic imaging:

Assessing the urinary tract using ultrasound, CT and MRI scanning, radiation tracking, or X-rays to rule out the cause.

Cystoscopy:

This procedure involves looking inside the bladder and urethra with a camera lens inserted in to the urethra through a long thin tube.

Urodynamics:

A procedure that determines how well the urinary tract is storing and releasing urine.

Treatment of UTIs:

Urinary tract infections are most commonly treated with antibiotics or antimicrobials as they are normally caused by bacteria. The type of medication and duration of treatment will depend on the patient's symptoms and history. UTI symptoms can disappear before the infection has completely gone. But it is always recommended to complete the full course of antibiotics for UTIs to make sure that the infection is fully clear, and to reduce the risk of antibiotic resistance.
For people who have UTIs, it is recommended to drink lots of fluids and frequently urinate as this helps  to flush out the bacteria. Pain relief medications may be prescribed to alleviate pain. Applying a heating pad to the back or abdomen can also help.
An uncomplicated UTI is one that occurs in an otherwise healthy person with a normal clear urinary tract which can usually be cured with 2 to 3 days of treatment.
A complicated UTI is one that occurs in a person who is weakened by another condition, such as pregnancy or heart transplant which may requires longer periods (usually between 7 to 14 days) of antibiotics. 
UTI that is caused by problems within the urinary system, the underlying issue needs to be found and treated. If left untreated, these infections can lead to kidney damage.  

UTI patients may need hospitalization if they:

• Have cancer, diabetes, multiple sclerosis, spinal cord injury, or other medical problems.
• Have recently undergone urinary tract surgery
• Have kidney stones or other changes in the anatomy of their urinary tract
• Are elderly
• Are pregnant and are otherwise ill

Recurrent infections in women:

If a women have recurrent bladder infections, she may be advised to:

• Take a short course may be 2 to 3 days of an antibiotic if symptoms reappear.
• Take a single, daily dose of an antibiotic for at least 6 months.
• Have vaginal estrogen therapy if postmenopausal.
• Take a single dose of an antibiotic after sexual contact.

Prevention of UTIs:

To reduce the risk of developing a UTI, you are advised to do the following things:

• Keep the genital area clean
• Wipe from front to back after urinating and bowel movement
• Drink lots of water and urinate frequently
• Sanitary pads or menstrual cups are preferred to tampons
• Avoid using a diaphragm or spermicide for birth control
• Avoid using any perfumed products in the genital area
• Wear cotton underwear and loose-fitting clothing to keep the area around the urethra dry
• Avoid fluids such as alcohol and caffeine that can irritate the bladder

Cranberry, probiotics, and UTIs:

Cranberry extracts do not help treat existing UTIs but may help prevent the development of UTIs. This is because cranberries contain proanthocyanidins, a compounds that prevent E. coli from sticking to the walls of the digestive and urinary tract.
Cranberry extracts also contain anthocyanins and salicylic acid, which may exert an analgesic and anti-inflammatory effect that can help alleviate UTI symptoms.
Regular use of probiotics may help reduce the risk of UTIs, especially after a course of antibiotics.