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UTI: Urinary Tract Infection

WITHOUT A CATHETER

  • UTI = consistently cloudy urine + increased urine odor + consistent burning with urination + increased urgency/frequency of urination

  • If it's only burning with urination that is occasional, and there are no other UTI symptoms, it's unlikely to be UTI and antibiotics won't help.

    • Drinking plenty of water, making sure you are having regular daily bowel movements, and sometimes, temporary over the counter AZO can help in this specific situation of isolated burning with urination. The burning is likely nerve related and will improve with time and constipation resolution.

  • Colonization: some patients will have urinaylses or urine cultures that show evidence of infection. If the urine is clear and the patient has no UTI symptoms, they are colonized and antibiotics are usually not helpful. Treatment of an abnormal urine test when no symptoms of UTI are present may breed multi-drug resistant bacteria that won't respond to oral antibiotics and potentially lead to more dangerous types of infections.

WITH A CATHETER

  • UTI = consistently cloudy urine + increased urine odor + increased frequency/urgency/bladder spasms (strong uncomfortable and sometimes painful urge to urinate)

  • Urinary tests in patients with a catheter:

    • Most lab tests will show evidence of blood in the urine and infection. However, if patients do not have symptoms of a UTI as listed above, this is colonization with bacteria and not infection. This is not treated in most cases as inappropriate antibiotic use can create resistant bacteria.

PREVENTION

  • Behavioral/diet management:

    • ▶️ hydration: drinking >1.5L of water vs <1.5L (UTIS per yr 1.7 vs 3.2)

    • ▶️ pelvic floor PT

    • ▶️ cranberry proanthocyanidins: juice vs supplements

    • Video link: Dr. Una Lee discussion Recurrent UTIs

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G.U. Recon Mang Chen MD 2019  

G.U. Recon Clinic

45 Castro St. Ste 111

San Francisco, CA 94114

Office: 415-481-3890

Fax: 309-328-3827

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