Overview#
A Urinary Tract Infection (UTI) is a bacterial infection affecting any part of the urinary system – most commonly the bladder (cystitis) and urethra (urethritis). UTIs are among the most common infections globally, affecting approximately 50 % of women at least once in their lifetime. In India, the incidence is particularly high due to hot and humid climate, inadequate hydration, poor sanitation in some areas, and cultural reluctance to discuss urinary symptoms. Women are 8-10 times more likely to develop UTIs than men due to shorter urethral length.
Causes & Risk Factors#
- E. coli bacteria – responsible for 80-85 % of community-acquired UTIs; migrates from the gut to the urinary tract.
- Female anatomy – shorter urethra and proximity to the anal area facilitate bacterial entry.
- Sexual activity – increases risk, especially with new partners ("honeymoon cystitis").
- Dehydration – concentrated urine and infrequent urination allow bacteria to multiply; a major factor in hot Indian climates.
- Diabetes mellitus – elevated glucose in urine promotes bacterial growth; diabetics have 2-3 times higher UTI risk.
Signs & Symptoms#
- Burning sensation during urination (dysuria)
- Frequent urge to urinate with only small amounts passed
- Cloudy, dark, or strong-smelling urine
- Lower abdominal or pelvic pain/pressure
- Blood in urine (haematuria) – pink or cola-coloured
- Urgency – sudden, intense need to urinate
- Fever and chills (suggests upper UTI/pyelonephritis)
- Flank pain or back pain on one side (kidney infection)
Diagnosis#
- Urine Routine and Microscopy – detects pus cells (pyuria), bacteria, and red blood cells. Book Urine Test
- Urine Culture and Sensitivity (C&S) – identifies the specific bacteria and which antibiotics it is susceptible to. This is the gold standard test. Book Urine Culture
- Complete Blood Count – elevated WBC count may indicate systemic infection. Book CBC
- Ultrasound KUB (Kidneys, Ureter, Bladder) – recommended for recurrent UTIs or suspected complications (kidney stones, obstruction).
Treatment Options#
Antibiotics (based on culture sensitivity):
- Uncomplicated cystitis: Nitrofurantoin (5 days) or fosfomycin (single dose) are first-line. Fluoroquinolones (norfloxacin, ciprofloxacin) are now reserved for complicated cases due to rising resistance in India.
- Pyelonephritis (kidney infection): Oral or IV fluoroquinolones or cephalosporins for 7-14 days.
- Important: Complete the full course of antibiotics even if symptoms improve. Incomplete courses drive antibiotic resistance, which is a major problem in India.
Supportive care:
- Drink at least 2-3 litres of water daily to flush bacteria.
- Urinary analgesics (phenazopyridine) for symptom relief in the first 1-2 days.
- Avoid holding urine – empty the bladder every 3-4 hours.
Prevention#
- Drink at least 2-3 litres of water daily, more in hot weather.
- Urinate frequently – do not hold urine for prolonged periods.
- Urinate within 30 minutes after sexual intercourse to flush bacteria.
- Wipe front to back after using the toilet.
- Avoid douching and strong vaginal cleansers – these disrupt protective bacteria.
When to See a Doctor#
Consult a doctor if you have burning urination lasting more than 2 days, blood in urine, or lower abdominal pain. Seek urgent care for high fever with UTI symptoms (suggests kidney infection), flank pain, vomiting, or inability to keep fluids down. Pregnant women with UTI symptoms must see a doctor immediately – untreated UTIs can cause preterm labour and kidney complications.