UTIs: Signs, Symptoms & Diagnosis

A urinary tract infection (UTI) may be a very annoying and uncomfortable experience. However, you may have one without realizing it. Not everyone with a UTI will exhibit noticeable symptoms. When symptoms do occur, they may vary greatly from one person to another. The symptoms that many women experience include:

• Dysuria, pain or burning during urination. The infection, particularly in the urethra, may make urination painful.
• Intense or frequent urges to urinate. This may occur even if there is little urine to pass. Bladder infection can make you feel that your bladder is very full when it is not.
• Dyspareunia, pain during sexual intercourse. Because of the close relation of the urinary tract and sexual organs, an infection in the urinary tract can sometimes make intercourse painful.
• Other pain. Pain may also occur elsewhere. In particular, your lower back, pelvic area or abdomen may hurt.
• Abnormal urine. Your urine may be dark, cloudy or bloody. It may not smell right. This is due to the presence of bacteria.
• Fatigue. A UTI may make you feel tired, weary or worn-out.
• Nocturia, awakening from sleep to urinate. The urge to urinate may wake you up at night.
• Enuresis, bedwetting

In cases where a UTI has progressed to a kidney infection (pyelonephritis), individuals may experience more serious symptoms. These can include chills, fever, nausea and vomiting.

UTIs do not only occur in adults. The urinary tracts of children may become infected too. However, symptoms of urinary tract infection are often overlooked in children. Notify your child's doctor if your infant or child:

• Appears irritable
• Has a decreased appetite
• Has an unexplained, persistent fever
• Has loose bowels or can't control her bladder
• Is not growing and developing properly

Women develop UTIs more often than men. This is because men have longer urethras than women, so the bacteria have to travel farther. However, if your partner or spouse does develop a urinary tract infection, it may be more serious and more difficult to treat than a similar infection in a woman. UTIs can also be more dangerous for pregnant women, women with compromised immune function (such as those with diabetes), older women and women who have trouble urinating due to various conditions, such as blockage in the urethra, bladder dysfunction or poor muscle control.

If you experience any of the symptoms of a urinary tract infection, consult your doctor. This is especially important if you are pregnant. UTIs are more likely to travel to your kidneys during this time because of hormonal changes and the repositioning of your urinary tract, which shifts during pregnancy to make room for the developing baby. Kidney infection during pregnancy may lead to many complications, such as high blood pressure, kidney damage, premature delivery or urosepsis, a life-threatening blood infection. However, if a UTI is caught early, it can be treated before these complications occur. Because of this, all pregnant women need to have their urine tested periodically over the course of their pregnancy.

Diagnosing UTIs

The diagnosis of a UTI typically begins with a medical history. You will need to tell your physician about your symptoms and past medical conditions. Your doctor will ask you several questions, such as:

• How much fluid do you drink?
• Do you experience a burning sensation when you urinate?
• Do you ever have difficulty urinating?
• Have you ever had a UTI before?

You may also be asked about the type of birth control you use. It is important to answer all questions as completely as you can. It may be helpful to prepare a list of the details of your symptoms before your appointment.

After your medical history is collected, your doctor will conduct a physical examination, which may include a pelvic exam. Your doctor may also order certain tests that require you to give a urine sample. These include:

• Urinalysis, in which a sample of your urine is examined in a laboratory to identify blood or protein in the urine.
• Urine culture, in which a sample of your urine is placed in special conditions that will allow any bacteria in it to grow. This determines the type of bacteria causing the infection.

If you have experienced recurring UTIs, additional tests may be performed to create images of your urinary tract or allow your doctor to see inside it. These tests may include:

• Intravenous pyelogram (IVP). This is a series of X-rays of the entire urinary tract. It is usually done after a special contrast agent (a dye) has been injected into your bloodstream. This may not be safe during pregnancy.
• Ultrasound. High-frequency sound waves are used to create images of the urinary tract. This is a noninvasive procedure that involves little or no discomfort and is safe for use during pregnancy. In fact, ultrasound is often used to create images of developing babies inside their mothers' wombs.
• Computed tomography (CT) scan. A series of X-rays are taken from all around you to create a three-dimensional image of your kidneys and urinary system. Like IVP, this may not be safe during pregnancy.
• Cystoscopy. A visual examination of inside the bladder is conducted using an instrument called a cystoscope. A cystoscope is a thin, long, lighted instrument with a tiny camera that is inserted into the bladder through the urethra. Cystoscopy is usually safe during pregnancy.

If you have had two or more UTIs, you may be referred to a urologist (a doctor who specializes in urinary disorders). Your urologist will have more experience with the diagnosis and treatment of UTIs and may be able to do more for you than your regular doctor.

A UTI may have few or no symptoms. On the other hand, it may cause several annoying symptoms, including various painful ones. However, UTIs are usually easy to diagnose and, once diagnosed, easily treated.