By James N. Martin, Jr, MD
President, the American Congress of Obstetricians and Gynecologists

Urinary tract infections (UTIs) are a common problem that affect up to 60% of women. They can be painful and may cause serious illness, especially if the infection spreads to the kidneys.

UTIs usually occur when bacteria that live on the skin near the rectum or in the vagina enter the urinary tract. The urinary tract consists of four parts: the kidneys which produce urine; the ureters which take urine from the kidneys to the bladder; the bladder, where urine is stored; and the urethra, which takes urine out of the body. Sexual contact or wiping back to front can transport bacteria to the urethra. The bacteria can then spread to the bladder, ureters, and kidneys. UTIs may also be caused by a blockage (stone) in the kidneys, bladder, or ureters; a narrowed tube or kink in the urinary tract; or problems with the bladder wall, urethra, or pelvic muscles or nerves.

A UTI can cause a strong urge to urinate that cannot be delayed, an urge to urinate very frequently, or a sharp pain or burning in the urethra as you urinate. Your urine may look cloudy, have a strong odor, or be tinged with blood. Additionally, if you have back pain, chills, fever, nausea, or vomiting, the infection may have spread to your kidneys. Kidney infections must be treated right away. Contact your doctor if you experience any of these symptoms.

UTIs can be quickly diagnosed with a urine test. Your doctor will prescribe an antibiotic to clear up the infection. Most symptoms go away in a day or two, but it is important to finish all of the prescribed medication to lower the risk of the infection coming back. Recurrent infections may signal other problems with the urinary tract, and your doctor may need to perform more tests to make sure there is not a more serious problem.

You may be at higher risk for UTIs if you are obese, diabetic, have had UTIs before, have sickle cell trait, are post-menopausal, have diabetes, use a diaphragm or spermicide for contraception, have intercourse frequently, or have a new partner.

These tips may help prevent UTIs:

• Always wipe front to back after bowel movements and urination

• Avoid using douches, powder, and deodorant sprays

• Drink plenty of fluids, including water and cranberry juice

• Empty your bladder as soon as you get the urge, about every 2–3 hours

• Try to empty your bladder before and after sex

• Wear cotton underwear

For more information, the Patient Education Pamphlet “Urinary Tract
Infections” is available in English and Spanish at www.acog.org/publications/patient_education.