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Urinary tract infections (UTIs) may be sudden (acute), recurrent or persistent (chronic), and they may or may not involve symptoms. People with a UTI may need to urinate more frequently than usual, have problems with urinary continence, or feel that the bladder does not empty as normal. The person’s urine may also look bloody or cloudy and have an unusual smell. 

A UTI may also cause pain either when starting to pass urine or after passing urine. The pain may be burning or stinging or involve an aching discomfort in the lower abdomen. There may also be general symptoms such as fever, feeling sick, chills or vomiting. In men, discharge at the urethral orifice may also indicate gonorrhoea or chlamydia. 

Urinary tract infections are classified on the basis of the level of the infection:

  • Infection in the lower urinary tract, urethra and bladder = cystitis (common)
  • Infection in the upper urinary tract (renal pelvis, kidneys) = pyelonephritis (rare)
  • Infection of the urethra, also known as urethritis, is quite uncommon and, unlike the others, often caused by a sexually transmitted disease (STD).

Self-care

Mild symptoms can be treated by increasing daily fluid intake to about 2–2.5 litres. Cranberry products may be helpful; they make the urine more acidic, which prevents bacterial growth. Cranberry products are available both in capsule form and in juice form. 

In terms of self-care for a UTI, it is important to wash the genital area in the mornings and evenings and after having sex. Water is enough; excessive washing or using hygiene products might promote the development of a UTI or worsen an existing UTI. It is also a good idea to empty the bladder every time before going swimming or having a bath. Avoiding products that cause constipation also helps to clear the infection. 

When should I seek treatment?

You should contact a health care professional if you have any of the symptoms described above and the self-care measures described are not helpful.

Treatment

In women with an acute UTI, antibiotics can be started without the need for a urine sample if the symptoms are typical and the woman is otherwise healthy. Otherwise, medication is always prescribed on the basis of urine test results. 

If you have recurrent UTIs (at least 3 or 4 times yearly), prophylactic treatment for 6 or 12 months may be used.

Women who have recurrent UTIs related to sexual intercourse may also use topical antiseptic products after having intercourse. It may also be useful to take a single dose of an antimicrobial agent after having sex.

Information sources: The Finnish Medical Society Duodecim: Terveysportti, Lääkärin tietokanta database

FSHS General Practitioner / 2 September 2019

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