Urinary Tract Infections

The first signs that you have a urinary tract infection (UTI) are burning when you pee and urinary frequency (peeing a whole lot!). 🚽 A UTI occurs when bacteria gets into your urinary tract (somewhere between your kidneys, bladder, and where the pee comes out) and causes irritation and inflammation (UGH!). Don’t fret…most urinary tract infections can be easily treated with antibiotics.  

Usually UTIs are caused by e.coli. E.coli is a bacteria that normally lives in your intestines. It hangs out in your poop 💩 (EW GROSS). Annoyingly, e.coli can jump from your poop and make its way unto the urethra, the tube that connects your bladder to the outside world through your vagina or penis.  Now don’t panic. Your anus (poop hole) and your urethra (pee hole) are very close. All it takes is one bad wipe or smear and the bacteria can get close enough to cause an infection. Other things can cause urinary symptoms too. Here you can read about smelly urine and funny colored urine. Females and uncircumcised males are more likely to get UTIs than circumcised males, but anyone can get one.

Symptoms of a UTI

The first symptoms of a UTI are usually some mild discomfort with urination or in the lower abdominal (i.e. belly) region. The discomfort quickly progresses to full blown pain with urination.  You may have urinary frequency and the urge to pee, but only small amounts come out. Some people see blood in the toilet when they wipe. 🚽  As the UTI worsens, you may develop a fever and can also have back, belly, or pain in your side (“flank pain”).  Sometimes people have vomiting and overall feel pretty cruddy or flu-like. These are all reasons you should be seen right away for a urine test.  Any symptoms that get worse quickly should be seen more urgently.  

Children, especially babies, often have no symptoms other than fever. 🤒 If your baby is under 3 months and has a fever, please call your pediatric provider right away. 👶If your baby of 3 months and over has had fever for more than 24 hours with no other symptoms, they could have a UTI and need to be checked out. Same goes for your toddler child who has had a fever for more than 2-3 days with no symptoms at all. They could have a UTI and need to be checked as well. Like adults, some children might have a small amount of blood in their diaper or in their urine. Definitely call your pediatric provider or get them checked out if that happens

Some elderly adults 👵with a UTI will have no symptoms other than some confusion and agitation. So, if grandma suddenly seems like she is confused, it is a good idea to have her checked out too. 

How to prevent UTIs in women

Let’s talk vaginas first.  Now, you can try and reduce your risk for UTIs by doing the following.  First, wiping front to back is a great idea. Keeping the bacteria in your poop 💩 away from your vaginal area is the best way to avoid getting a UTI.  If you started wearing thong underwear and have found that you suddenly have vaginal irritation and frequent UTIs then it might be time to ditch those undies for some full coverage.  They don’t call thongs butt floss for no reason!  

It’s also important to void (pee) before and after having sexual intercourse.  This will help to flush out any bacteria that may have gotten pushed up into the urethra during sex. Good hygiene is important.  Make sure to keep things clean! A shower 🚿 before sex or a wet wipe can help keep things fresh.  

How to prevent UTIs in men

Hygiene is an important part of preventing UTIs in men. 🍆  In uncircumcised men, it’s important to gently pull back the foreskin (skin covering the penis’ tip) to allow cleaning of the tip of the penis underneath (especially the area where the tip of the penis and the foreskin meet!).  Dry the skin before retracting back your foreskin. Keeping things clean will decrease the risk of bacteria getting into your urethra. The less “smegma,” the better for everyone involved! Drinking lots of fluids will help flush the urethra, as well as voiding (peeing) before and after sex.  This is especially important with anal sex. E.coli is the most common bacteria to cause UTI’s and it is found in the stool 💩 (poo).  

UTIs in children

Kiddos can get UTIs as well. They are more common in girls when they begin to potty train but boys can get them too. 🚽 Kids are notorious for poor wiping skills so it’s important to do it for them until they clearly have the ability to do it correctly themselves. If they are doing it solo, remind them to wipe extra and always front to back (starting with the vagina/penis and back to the butt). Check those little bums for poop debris!  

Kids are really good at holding their urine and poop too. 🙄🙄 Holding urine can increase their risk for UTIs.  Make sure to offer them water throughout the day and encourage bathroom breaks. If they are starting to hold it in on a regular basis, check out our article on constipation for some tips and tricks. 

In uncircumcised boys it’s important to keep the penis clean. Now, they are a little different than adult males.  You should NOT pull back the foreskin of the penis. You can gently wash the tip of the penis. 🍆 It’s ok to push the skin slightly to expose the tip, but pulling back the skin can cause scarring and pain.   Warm baths are a great way to loosen up any debris and gently clean under the foreskin. As your child grows, the penis will naturally stretch the foreskin and it will eventually pull back as the connections between the tip of the penis and the foreskin break apart on their own.  Your child will naturally help this process along as they discover their penis in the bath and help the skin to gradually and gently stretch over time without causing pain or injury to themselves.

Drink lots of fluids

Drinking lots of fluids in general will help to flush the urethra in all people.  🚰 Keeping hydrated with water is important in a lot of ways, one being to keep your urine moving along which helps to prevent bacteria from climbing up your urethra.  Light yellow to clear urine is a great sign that you are drinking enough water. Darker yellow/orange urine means you are dehydrated and need to drink more water!  

What to expect at your visit

At the visit with your medical provider, you will need to produce a urine sample.  Drink lots of fluids and ask for a cup if you are feeling like you or your child can’t hold it any longer and you are still in the waiting room.  Otherwise you might be spending some time downing popsicles and trying to get a few drops of urine for the test. 

If your child is too young and can’t pee on demand, they may need to use a small plastic sterile tube (catheter) inserted into the urethra to obtain urine from the bladder. Your child will not be happy about being held down for this! However, it’s quick, safe, done frequently, and your child won’t recall the procedure later in life.

Urine test results for UTIs

Once your urine test is back, there will be some indication that there is an infection in your urine.  This test is usually pretty quick. There is usually bacteria and sometimes small amounts of blood or nitrites in your urine if you have a UTI.  The urine will then be sent off to the lab to be cultured. This is how they find out what kind of bacteria (if any) is growing in your urine, so that you can get the best antibiotic for the job.  

If your provider thinks that this is a UTI, they will likely start antibiotics 💊 while they wait for the culture results.  Your antibiotic should start working within 24-48 hours and you should start to feel better around that time. Until then, you definitely shouldn’t be feeling much worse, so if that happens check back with your provider. 

Sometimes the results of urine test aren’t perfectly clear if you have a UTI or not. The provider doing the test may or may not wait another 24 hours for the culture test to come back before deciding whether to give you antibiotics or not. 

Kids with UTIs sometimes need extra testing of the kidneys to be sure that they look ok and are draining properly.  If you child has a fever and has a UTI, then discuss the plan for getting more testing with your primary care provider.  

Call with any concerns

Chat with us regarding your concerns. We are happy to help.  There are other things that can cause urinary discomfort too. Check out our articles on foul smelling urine and STDs/STIs in women and STDs/STIs in men.  

–Kim Liner, RN, MSN, CPNP

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