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• Too$s an' Reso%ces

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Let9s Ta$6 A&o%t 2o/e$ Conto$

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Ho-e 4 Ki'ne) an' Uo$o(ic Diseases A8< List o" Topics an' Tit$es 4 Uina) Tact

In"ections in A'%$ts

Urinary $ract Infections in Adults

%n this #age&

• 5#at is a %ina) tact in"ection *UTI+=

• 5#at is t#e %ina) tact=

• 5#at ca%ses UTIs=

• Ho/ co--on ae UTIs in a'%$ts=

• 5#o is at is6 "o a UTI=

• Ae UTIs seio%s=

• 5#at ae t#e si(ns an' s)-pto-s o" a UTI=

• Ho/ ae UTIs 'ia(nose'=

• Ho/ ae UTIs teate'=

http://nkdep.nih.gov/http://www.bowelcontrol.nih.gov/http://www.celiac.nih.gov/http://kidney.niddk.nih.gov/kudiseases/topics/bladdercontrol.aspxhttp://www.nhlbi.nih.gov/health/public/heart/obesity/wecan/index.htmhttp://kidney.niddk.nih.gov/index.aspxhttp://kidney.niddk.nih.gov/kudiseases/a-z.aspxhttp://nkdep.nih.gov/http://www.bowelcontrol.nih.gov/http://www.celiac.nih.gov/http://kidney.niddk.nih.gov/kudiseases/topics/bladdercontrol.aspxhttp://www.nhlbi.nih.gov/health/public/heart/obesity/wecan/index.htmhttp://kidney.niddk.nih.gov/index.aspxhttp://kidney.niddk.nih.gov/kudiseases/a-z.aspx

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• Ho/ can ec%ent UTIs &e pe!ente'=

• Points to Re-e-&e 

• Hope t#o%(# Reseac#

• Fo Moe In"o-ation

• Ac6no/$e'(-ents

'hat is a urinary tract infection (U$I)

A UTI is an in"ection in t#e %ina) tact. In"ections ae ca%se' &) -ico&es> 

o(anis-s too s-a$$ to &e seen /it#o%t a -icoscope>inc$%'in( "%n(i, !i%ses, an'

 &acteia. 2acteia ae t#e -ost co--on ca%se o" UTIs. No-a$$), &acteia t#at entet#e %ina) tact ae api'$) e-o!e' &) t#e &o') &e"oe t#e) ca%se s)-pto-s.

Ho/e!e, so-eti-es &acteia o!eco-e t#e &o')9s nat%a$ 'e"enses an' ca%se

in"ection. An in"ection in t#e %et#a is ca$$e' %et#itis. A &$a''e in"ection is ca$$e'

c)stitis. 2acteia -a) ta!e$ %p t#e %etes to -%$tip$) an' in"ect t#e 6i'ne)s. A 6i'ne)

in"ection is ca$$e' p)e$onep#itis.

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'hat is the urinary tract

T#e %ina) tact is t#e &o')s 'aina(e s)ste- "o e-o!in( /astes an' eBta /ate.

T#e %ina) tact inc$%'es t/o 6i'ne)s, t/o %etes, a &$a''e, an' a %et#a. T#e

6i'ne)s ae a pai o" &ean8s#ape' o(ans, eac# a&o%t t#e sie o" a "ist an' $ocate'

 &e$o/ t#e i&s, one on eac# si'e o" t#e spine, to/a' t#e -i''$e o" t#e &ac6. E!e)

-in%te, a peson9s 6i'ne)s "i$te a&o%t o%nces o" &$oo', e-o!in( /astes an' eBta

/ate. T#e /astes an' eBta /ate -a6e %p t#e to 0 %ats o" %ine a peson

 po'%ces eac# 'a). T#e %ine ta!e$s "o- t#e 6i'ne)s 'o/n t/o nao/ t%&es ca$$e'

t#e %etes. T#e %ine is t#en stoe' in a &a$$oon$i6e o(an ca$$e' t#e &$a''e an'

e-ptie' t#o%(# t#e %et#a, a t%&e at t#e &otto- o" t#e &$a''e.

5#en t#e &$a''e e-pties, a -%sc$e ca$$e' t#e sp#incte e$aBes an' %ine "$o/s o%t

o" t#e &o') t#o%(# t#e %et#a. T#e openin( o" t#e %et#a is at t#e en' o" t#e penis in

-a$es an' in "ont o" t#e !a(ina in "e-a$es.

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T#e %ina) tact

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'hat causes U$Is

Most UTIs ae ca%se' &) &acteia t#at $i!e in t#e &o/e$. T#e &actei%- Escherichia

coli (E. coli) ca%ses t#e !ast -aGoit) o" UTIs. Mico&es

ca$$e' Chlamydiaan' Mycoplasma can in"ect t#e %et#a an' epo'%cti!e s)ste- &%t

not t#e &$a''e. Chlamydia an' Mycoplasma in"ections -a) &e seB%a$$) tans-itte'

an' e%ie teat-ent o" seB%a$ patnes.

T#e %ina) tact #as se!ea$ s)ste-s to pe!ent in"ection. T#e points /#ee t#e

%etes attac# to t#e &$a''e act $i6e one8/a) !a$!es to pe!ent %ine "o- &ac6in( %p

to/a' t#e 6i'ne)s, an' %ination /as#es -ico&es o%t o" t#e &o'). In -en, t#e

 postate ($an' po'%ces secetions t#at s$o/ &acteia$ (o/t#. In &ot# seBes, i--%ne

'e"enses a$so pe!ent in"ection. 2%t 'espite t#ese sa"e(%a's, in"ections sti$$ occ%.

Cetain &acteia #a!e a ston( a&i$it) to attac# t#e-se$!es to t#e $inin( o" t#e %ina)

tact.

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Ho" common are U$Is in adults

Uina) tact in"ections ae t#e secon' -ost co--on t)pe o" in"ection in t#e &o'),

acco%ntin( "o a&o%t . -i$$ion !isits to #ea$t# cae po!i'es eac# )ea. 5o-en ae

especia$$) pone to UTIs "o anato-ica$ easons. One "acto is t#at a /o-an9s %et#a

is s#ote, a$$o/in( &acteia %ic6e access to t#e &$a''e. A$so, a /o-an9s %et#a$

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openin( is nea so%ces o" &acteia "o- t#e an%s an' !a(ina. Fo /o-en, t#e $i"eti-e

is6 o" #a!in( a UTI is (eate t#an J pecent.0 UTIs in -en ae not as co--on as in

/o-en &%t can &e seio%s /#en t#e) occ%.

Sc#appet SM, Rec#tsteine EA. A-&%$ato) -e'ica$ cae %ti$iation esti-ates "o

0JJ1. Nationa$ #ea$t# statistics epots no . H)atts!i$$e, MD4 Nationa$ Cente "oHea$t# Statistics 0JJ.

07ie&$in( TL. Uina) tact in"ection in /o-en. In4 Lit/in MS, Sai(a$ CS,

e's. Urologic Diseases in America. Depat-ent o" Hea$t# an' H%-an Se!ices, P%&$ic

Hea$t# Se!ice, Nationa$ Instit%tes o" Hea$t#, Nationa$ Instit%te o" Dia&etes an'

Di(esti!e an' Ki'ne) Diseases. 5as#in(ton, D.C.4 7PO 0JJ. NIH p%&$ication J 

041.

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'ho is at ris for a U$I

A$t#o%(# e!e)one #as so-e is6, so-e peop$e ae -oe pone to (ettin( UTIs t#an

ot#es. Peop$e /it# spina$ co' inG%ies o ot#e ne!e 'a-a(e ao%n' t#e &$a''e

#a!e 'i""ic%$t) e-pt)in( t#ei &$a''e co-p$ete$), a$$o/in( &acteia to (o/ in t#e

%ine t#at sta)s in t#e &$a''e. An)one /it# an a&no-a$it) o" t#e %ina) tact t#at

o&st%cts t#e "$o/ o" %ine>a 6i'ne) stone o en$a(e' postate, "o eBa-p$e>is at

is6 "o a UTI. Peop$e /it# 'ia&etes o po&$e-s /it# t#e &o')9s nat%a$ 'e"ense

s)ste- ae -oe $i6e$) to (et UTIs.

SeB%a$ acti!it) can -o!e -ico&es "o- t#e &o/e$ o !a(ina$ ca!it) to t#e %et#a$

openin(. I" t#ese -ico&es #a!e specia$ c#aacteistics t#at a$$o/ t#e- to $i!e in t#e

%ina) tact, it is #a'e "o t#e &o') to e-o!e t#e- %ic6$) eno%(# to pe!ent

in"ection. Fo$$o/in( seB%a$ inteco%se, -ost /o-en #a!e a si(ni"icant n%-&e o"

 &acteia in t#ei %ine, &%t t#e &o') no-a$$) c$eas t#e- /it#in 0 #o%s. Ho/e!e,

so-e "o-s o" &it# conto$ incease t#e is6 o" UTI. In so-e /o-en, cetain

spe-ici'es -a) iitate t#e s6in, inceasin( t#e is6 o" &acteia in!a'in( s%o%n'in(

tiss%es. Usin( a 'iap#a(- -a) s$o/ %ina) "$o/ an' a$$o/ &acteia to -%$tip$).

Con'o- %se is a$so associate' /it# incease' is6 o" UTIs, possi&$) &eca%se o" t#e

incease' ta%-a t#at occ%s to t#e !a(ina '%in( seB%a$ acti!it). Usin( spe-ici'es/it# 'iap#a(-s an' con'o-s can incease is6 e!en "%t#e.

Anot#e co--on so%ce o" in"ection is cat#etes, o t%&es, p$ace' in t#e %et#a an'

 &$a''e. Cat#etes inte"ee /it# t#e &o')9s a&i$it) to c$ea -ico&es "o- t#e %ina)

tact. 2acteia ta!e$ t#o%(# o ao%n' t#e cat#ete an' esta&$is# a p$ace /#ee t#e)

can t#i!e /it#in t#e &$a''e. A peson /#o cannot %inate in t#e no-a$ /a) o /#o

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is %nconscio%s o citica$$) i$$ o"ten nee's a cat#ete "o -oe t#an a "e/ 'a)s. T#e

In"ectio%s Diseases Societ) o" A-eica eco--en's %sin( cat#etes "o t#e s#otest

ti-e possi&$e to e'%ce t#e is6 o" a UTI.

Recurrent Infections

Man) /o-en s%""e "o- "e%ent UTIs. A&o%t 0J pecent o" )o%n( /o-en /it# a

"ist UTI /i$$ #a!e a ec%ent in"ection. 5it# eac# UTI, t#e is6 t#at a /o-an /i$$

contin%e #a!in( ec%ent UTIs inceases. So-e /o-en #a!e t#ee o -oe UTIs a

)ea. Ho/e!e, !e) "e/ /o-en /i$$ #a!e "e%ent in"ections t#o%(#o%t t#ei $i!es.

Moe t)pica$$), a /o-an /i$$ #a!e a peio' o" o 0 )eas /it# "e%ent in"ections,

a"te /#ic# ec%in( in"ections cease.

Men ae $ess $i6e$) t#an /o-en to #a!e a "ist UTI. 2%t once a -an #as a UTI, #e is

$i6e$) to #a!e anot#e &eca%se &acteia can #i'e 'eep insi'e postate tiss%e. An)one

/#o #as 'ia&etes o a po&$e- t#at -a6es it #a' to %inate -a) #a!e epeatin"ections.

Reseac# "%n'e' &) t#e Nationa$ Instit%tes o" Hea$t# *NIH+ s%((ests t#at one "acto

 &e#in' ec%ent UTIs -a) &e t#e a&i$it) o" &acteia to attac# to ce$$s $inin( t#e

%ina) tact. One NIH8"%n'e' st%') "o%n' t#at &acteia "o-e' a potecti!e "i$- on

t#e inne $inin( o" t#e &$a''e in -ice.1 I" a si-i$a pocess can &e 'e-onstate' in

#%-ans, t#e 'isco!e) -a) $ea' to ne/ teat-ents to pe!ent ec%ent UTIs. Anot#e

$ine o" eseac# #as in'icate' t#at /o-en /#o ae nonsecetos o" cetain &$oo'

(o%p anti(ens -a) &e -oe pone to ec%ent UTIs &eca%se t#e ce$$s $inin( t#e

!a(ina an' %et#a -a) a$$o/ &acteia to attac# -oe easi$). A nonseceto is a peson/it# an A, 2, o A2 &$oo' t)pe /#o 'oes not secete t#e no-a$ anti(ens "o t#at

 &$oo' t)pe in &o'i$) "$%i's, s%c# as "$%i's t#at $ine t#e &$a''e /a$$.

Infections during !regnancy

Pe(nant /o-en see- no -oe pone to UTIs t#an ot#e /o-en. Ho/e!e, /#en a

UTI 'oes occ% in a pe(nant /o-an, it is -oe $i6e$) to ta!e$ to t#e 6i'ne)s.

Acco'in( to so-e epots, a&o%t to pecent o" pe(nant /o-en 'e!e$op a

UTI. Scientists t#in6 t#at #o-ona$ c#an(es an' s#i"ts in t#e position o" t#e %ina)

tact '%in( pe(nanc) -a6e it easie "o &acteia to ta!e$ %p t#e %etes to t#e6i'ne)s an' ca%se in"ection. Fo t#is eason, #ea$t# cae po!i'es o%tine$) sceen

 pe(nant /o-en "o &acteia in t#e %ine '%in( t#e "ist -ont#s o" pe(nanc).

Hooton TM, et a$. Dia(nosis, pe!ention, an' teat-ent o" cat#ete8associate' %ina)

tact in"ection in a'%$ts4 0JJ intenationa$ c$inica$ pactice (%i'e$ines "o- t#e

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In"ectio%s Diseases Societ) o" A-eica. Clinical Infectious Diseases. 0JJJ*+410 

11.

To$6o""8R%&in NE, Cotan RS, R%&in RH. Uina) tact in"ection, p)e$onep#itis, an'

e"$%B nep#opat#). In4 2enne 2M, e'. Brenner & ector!s "he #idney. t# e'. Vo$.

0. P#i$a'e$p#ia4 Sa%n'es 0JJ4 0J0.

Sc#ae""e A. In"ections o" t#e %ina) tact. In4 5a$s# PC, Reti6 A2, Va%(#an ED,

5ein A, e's. Camp$ell!s Urology. t# e'. Vo$. . P#i$a'e$p#ia4 Sa%n'es 0JJ04  

1J0.

1An'eson 77, Pa$e-o , Sc#i$$in( D, et a$. Intace$$%$a &acteia$ &io"i$-8$i6e po's

in %ina) tact in"ections. %cience. 0JJJ4JJ.

Stap$eton AE, N%'e$-an E, C$a%sen H, Ha6o-oi S, Sta-- 5E. 2in'in( o"

%opat#o(enic Escherichia coli R to ($)co$ipi's eBtacte' "o- !a(ina$ epit#e$ia$ce$$s is 'epen'ent on #isto8&$oo' (o%p seceto stat%s. ournal of Clinical

 In'estigation. 0J10.

S#a-a 2, A((a/a$ S, Sin(#a$ S, K%-a S, Ro) KK. Pe!a$ence o" %ina)

incontinence an' ot#e %o$o(ica$ po&$e-s '%in( pe(nanc)4 a %estionnaie &ase'

st%'). Archi'es of ynecology and $stetrics. 0JJ0*1+4.

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Are U$Is serious

Most UTIs ae not seio%s, &%t so-e in"ections can $ea' to seio%s po&$e-s, s%c# as

6i'ne) in"ections. C#onic 6i'ne) in"ections>in"ections t#at ec% o $ast a $on( ti-e

 >can ca%se pe-anent 'a-a(e, inc$%'in( 6i'ne) scas, poo 6i'ne) "%nction, #i(#

 &$oo' pess%e, an' ot#e po&$e-s. So-e ac%te 6i'ne) in"ections>in"ections t#at

'e!e$op s%''en$)>can &e $i"e t#eatenin(, especia$$) i" t#e &acteia ente t#e

 &$oo'stea-, a con'ition ca$$e' septice-ia.

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'hat are the signs and sym#toms of a U$I

S)-pto-s o" a UTI !a) &) a(e, (en'e, an' /#et#e a cat#ete is pesent. A-on(

)o%n( /o-en, UTI s)-pto-s t)pica$$) inc$%'e a "e%ent an' intense %(e to %inate

an' a pain"%$, &%nin( "ee$in( in t#e &$a''e o %et#a '%in( %ination. T#e a-o%nt

o" %ine -a) &e !e) s-a$$. O$'e /o-en an' -en ae -oe $i6e$) to &e tie', s#a6),

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an' /ea6 an' #a!e -%sc$e ac#es an' a&'o-ina$ pain. Uine -a) $oo6 c$o%'), 'a6, o 

 &$oo') o #a!e a "o%$ s-e$$. In a peson /it# a cat#ete, t#e on$) s)-pto- -a) &e

"e!e t#at cannot &e atti&%te' to an) ot#e ca%se. No-a$$), UTIs 'o not ca%se "e!e

i" t#e) ae in t#e &$a''e. A "e!e -a) -ean t#e in"ection #as eac#e' t#e 6i'ne)s o

#as penetate' t#e postate. Ot#e s)-pto-s o" a 6i'ne) in"ection inc$%'e pain in t#e

 &ac6 o si'e &e$o/ t#e i&s, na%sea, an' !o-itin(.

?Top@

Ho" are U$Is diagnosed

To "in' o%t /#et#e a peson #as a UTI, t#e #ea$t# cae po!i'e /i$$ as6 a&o%t %ina)

s)-pto-s an' t#en test a sa-p$e o" %ine "o t#e pesence o" &acteia an' /#ite &$oo'

ce$$s, /#ic# ae po'%ce' &) t#e &o') to "i(#t in"ection. 2eca%se &acteia can &e

"o%n' in t#e %ine o" #ea$t#) in'i!i'%a$s, a UTI is 'ia(nose' &ase' &ot# on s)-pto-s

an' a $a&oato) test. T#e peson /i$$ &e as6e' to (i!e a c$ean catc# %ine sa-p$e &)/as#in( t#e (enita$ aea an' co$$ectin( a -i'stea- sa-p$e o" %ine in a stei$e

containe. T#is -et#o' o" co$$ectin( %ine #e$ps pe!ent &acteia ao%n' t#e (enita$

aea "o- (ettin( into t#e sa-p$e an' con"%sin( t#e test es%$ts. Us%a$$), t#e sa-p$e is

sent to a $a&oato), a$t#o%(# so-e #ea$t# cae po!i'es9 o""ices ae e%ippe' to 'o

t#e testin(. Fo peop$e /it# ec%in( in"ections an' patients in t#e #ospita$, t#e %ine

-a) &e c%$t%e'. T#e c%$t%e is pe"o-e' &) p$acin( pat o" t#e %ine sa-p$e in a

t%&e o 'is# /it# a s%&stance t#at enco%a(es an) &acteia pesent to (o/. Once t#e

 &acteia #a!e -%$tip$ie', /#ic# %s%a$$) ta6es to 'a)s, t#e) can &e i'enti"ie'. T#e

#ea$t# cae po!i'e -a) a$so o'e a sensiti!it) test, /#ic# tests t#e &acteia "o

sensiti!it) to 'i""eent anti&iotics to see /#ic# -e'ication is &est "o teatin( t#ein"ection.

I" a peson #as ec%ent UTIs, t#e #ea$t# cae po!i'e -a) o'e so-e a''itiona$

tests to 'ete-ine i" t#e peson9s %ina) tact is no-a$.

Kidney and *ladder ultrasound+ U$taso%n' %ses a 'e!ice, ca$$e' a tans'%ce, t#at

 &o%nces sa"e, pain$ess so%n' /a!es o"" o(ans to ceate an i-a(e o" t#ei st%ct%e.

T#e poce'%e is pe"o-e' in a #ea$t# cae po!i'e9s o""ice, o%tpatient cente, o

#ospita$ &) a specia$$) taine' tec#nician, an' t#e i-a(es ae intepete' &) a

a'io$o(ist>a 'octo /#o specia$ies in -e'ica$ i-a(in( anest#esia is not nee'e'.T#e i-a(es can s#o/ a&no-a$ities in t#e 6i'ne)s an' &$a''e. Ho/e!e, t#is test

cannot e!ea$ a$$ i-potant %ina) a&no-a$ities o -eas%e #o/ /e$$ t#e 6i'ne)s

/o6.

,oiding cystourethrogram+ T#is test is an B8a) i-a(e o" t#e &$a''e an' %et#a

ta6en /#i$e t#e &$a''e is "%$$ an' '%in( %ination, a$so ca$$e' !oi'in(. As t#e peson

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$ies on t#e B8a) ta&$e, a #ea$t# cae po!i'e insets t#e tip o" a t#in, "$eBi&$e t%&e

ca$$e' a cat#ete t#o%(# t#e %et#a into t#e &$a''e. T#e &$a''e an' %et#a ae

"i$$e' /it# a specia$ ')e ca$$e' contast -e'i%-, to -a6e t#e st%ct%es c$ea$) !isi&$e

on t#e B8a) i-a(es. T#e B a)s ae ta6en "o- !aio%s an($es /#i$e t#e &$a''e is "%$$

o" contast -e'i%-. T#e cat#ete is t#en e-o!e' an' B8a) i-a(es ae ta6en '%in(

%ination. T#e poce'%e is pe"o-e' in a #ea$t# cae po!i'e9s o""ice, o%tpatientcente, o #ospita$ &) an B8a) tec#nician. T#e tec#nician is s%pe!ise' &) a a'io$o(ist

/#i$e t#e i-a(es ae ta6en. T#e a'io$o(ist t#en intepets t#e i-a(es. Anest#esia is

not nee'e', &%t $i(#t se'ation -a) &e %se' "o so-e peop$e. T#is test can s#o/

a&no-a$ities o" t#e insi'e o" t#e %et#a an' &$a''e. T#e test can a$so 'ete-ine

/#et#e t#e "$o/ o" %ine is no-a$ /#en t#e &$a''e e-pties.

Com#uteri-ed tomogra#hy (C$) scan+ CT scans %se a co-&ination o" B a)s an'

co-p%te tec#no$o() to ceate t#ee8'i-ensiona$ *8D+ i-a(es. A CT scan -a)

inc$%'e t#e inGection o" contast -e'i%-. CT scans e%ie t#e peson to $ie on a ta&$e

t#at s$i'es into a t%nne$8s#ape' 'e!ice /#ee t#e B a)s ae ta6en. T#e poce'%e is

 pe"o-e' in an o%tpatient cente o #ospita$ &) an B8a) tec#nician, an' t#e i-a(es

ae intepete' &) a a'io$o(ist anest#esia is not nee'e'. CT scans can po!i'e

c$eae, -oe 'etai$e' i-a(es to #e$p t#e #ea$t# cae po!i'e %n'estan' t#e po&$e-.

.agnetic resonance imaging (.RI)+ MRI -ac#ines %se a'io /a!es an' -a(nets to

 po'%ce 'etai$e' pict%es o" t#e &o')9s intena$ o(ans an' so"t tiss%es /it#o%t %sin( B

a)s. An MRI -a) inc$%'e an inGection o" contast -e'i%-. 5it# -ost MRI -ac#ines,

t#e peson $ies on a ta&$e t#at s$i'es into a t%nne$8s#ape' 'e!ice t#at -a) &e open

en'e' o c$ose' at one en' so-e ne/e -ac#ines ae 'esi(ne' to a$$o/ t#e peson to

$ie in a -oe open space. T#e poce'%e is pe"o-e' in an o%tpatient cente o

#ospita$ &) a specia$$) taine' tec#nician, an' t#e i-a(es ae intepete' &) a

a'io$o(ist anest#esia is not nee'e' t#o%(# $i(#t se'ation -a) &e %se' "o peop$e

/it# a "ea o" con"ine' spaces. Li6e CT scans, MRIs can po!i'e c$eae, -oe

'etai$e' i-a(es.

Radionuclide scan+ A a'ion%c$i'e scan is an i-a(in( tec#ni%e t#at e$ies on t#e

'etection o" s-a$$ a-o%nts o" a'iation a"te inGection o" a'ioacti!e c#e-ica$s.

2eca%se t#e 'ose o" t#e a'ioacti!e c#e-ica$s is s-a$$, t#e is6 o" ca%sin( 'a-a(e to

ce$$s is $o/. Specia$ ca-eas an' co-p%tes ae %se' to ceate i-a(es o" t#e

a'ioacti!e c#e-ica$s as t#e) pass t#o%(# t#e 6i'ne)s. Ra'ion%c$i'e scans ae

 pe"o-e' in a #ea$t# cae po!i'e9s o""ice, o%tpatient cente, o #ospita$ &) a

specia$$) taine' tec#nician, an' t#e i-a(es ae intepete' &) a a'io$o(ist anest#esia

is not nee'e'. Ra'ioacti!e c#e-ica$s inGecte' into t#e &$oo' can po!i'e in"o-ation

a&o%t 6i'ne) "%nction. Ra'ioacti!e c#e-ica$s can a$so &e p%t into t#e "$%i's %se' to

"i$$ t#e &$a''e an' %et#a "o B a), MRI, an' CT i-a(in(.

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Urodynamics+ Uo')na-ic testin( is an) poce'%e t#at $oo6s at #o/ /e$$ t#e

 &$a''e, sp#inctes, an' %et#a ae stoin( an' e$easin( %ine. Most o" t#ese tests ae

 pe"o-e' in t#e o""ice o" a %o$o(ist>a 'octo /#o specia$ies in %ina) po&$e-s

 >&) a %o$o(ist, p#)sician assistant, o n%se pactitione. So-e poce'%es -a)

e%ie $i(#t se'ation to 6eep a peson ca$-. Most %o')na-ic tests "oc%s on t#e

 &$a''e9s a&i$it) to #o$' %ine an' e-pt) stea'i$) an' co-p$ete$). Uo')na-ic testscan a$so s#o/ /#et#e t#e &$a''e is #a!in( a&no-a$ contactions t#at ca%se $ea6a(e.

A #ea$t# cae po!i'e -a) o'e t#ese tests i" t#ee is e!i'ence t#at t#e peson #as

so-e 6in' o" ne!e 'a-a(e.

Cystosco#y+ C)stoscop) is a poce'%e t#at %ses a t%&e$i6e inst%-ent to $oo6 insi'e

t#e %et#a an' &$a''e. C)stoscop) is pe"o-e' &) a 'octo in a #ea$t# cae

 po!i'e9s o""ice, o%tpatient "aci$it), o #ospita$ /it# $oca$ anest#esia. Ho/e!e, in

so-e cases, se'ation an' e(iona$ o (enea$ anest#esia ae nee'e'. C)stoscop) -a)

 &e %se' to $oo6 "o s/e$$in(, e'ness, an' ot#e si(ns o" in"ection.

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Ho" are U$Is treated

Most UTIs ae ca%se' &) &acteia, /#ic# ae teate' /it# &acteia8"i(#tin(

-e'ications ca$$e' anti&iotics o anti-ico&ia$s. T#e c#oice o" -e'ication an' $en(t#

o" teat-ent 'epen' on t#e patient9s #isto) an' t#e t)pe o" &acteia ca%sin( t#e

in"ection. So-e anti&iotics -a) &e %$e' o%t i" a peson #as a$$e(ies to t#e-. T#e

sensiti!it) test ta6es #o%s to co-p$ete an' is especia$$) %se"%$ in #e$pin( t#e

#ea$t# cae po!i'e se$ect t#e anti&iotic -ost $i6e$) to &e e""ecti!e in teatin( anin"ection. Lon(e teat-ent -a) &e nee'e' i" t#e "ist anti&iotic (i!en is not e""ecti!e.

5#en a UTI occ%s in a #ea$t#) peson /it# a no-a$, %no&st%cte' %ina) tact, t#e

te- %nco-p$icate' is %se' to 'esci&e t#e in"ection. Most )o%n( /o-en /#o #a!e

UTIs #a!e %nco-p$icate' UTIs, /#ic# can &e c%e' /it# 0 o 'a)s o" teat-ent.

Sin($e8'ose teat-ent is $ess e""ecti!e. Lon(e teat-ent ca%ses -oe si'e e""ects an'

is not -oe e""ecti!e. A "o$$o/8%p %ina$)sis #e$ps to con"i- t#e %ina) tact is

in"ection8"ee. Ta6in( t#e "%$$ co%se o" teat-ent is i-potant &eca%se s)-pto-s -a)

'isappea &e"oe t#e in"ection is "%$$) c$eae'.

Co-p$icate' UTIs occ% /#en a peson>"o eBa-p$e, a pe(nant /o-an o a

tansp$ant patient>is /ea6ene' &) anot#e con'ition. A UTI is a$so co-p$icate'

/#en t#e peson #as a st%ct%a$ o "%nctiona$ a&no-a$it) o" t#e %ina) tact, s%c# as

an o&st%cti!e 6i'ne) stone o postate en$a(e-ent t#at s%eees t#e %et#a. Hea$t#

cae po!i'es s#o%$' ass%-e t#at -en an' &o)s #a!e a co-p$icate' UTI %nti$ po!en

ot#e/ise.

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Se!ee$) i$$ patients /it# 6i'ne) in"ections -a) &e #ospita$ie' %nti$ t#e) can ta6e

"$%i's an' nee'e' -e'ications on t#ei o/n. Ki'ne) in"ections -a) e%ie se!ea$

/ee6s o" anti&iotic teat-ent. Ki'ne) in"ections in a'%$ts ae$) $ea' to 6i'ne)

'a-a(e o 6i'ne) "ai$%e %n$ess t#e) (o %nteate' o ae associate' /it# %ina) tact

o&st%ction.

2$a''e in"ections ae (enea$$) se$"8$i-itin(, &%t anti&iotic teat-ent si(ni"icant$)

s#otens t#e '%ation o" s)-pto-s. Peop$e %s%a$$) "ee$ &ette /it#in a 'a) o t/o o"

teat-ent. S)-pto-s o" 6i'ne) an' postate in"ections $ast $on(e. Din6in( $ots o"

"$%i's an' %inatin( "e%ent$) /i$$ spee' #ea$in(. I" nee'e', !aio%s -e'ications ae

a!ai$a&$e to e$ie!e t#e pain o" a UTI. A #eatin( pa' on t#e &ac6 o a&'o-en -a) a$so

#e$p.

Recurrent Infections in 'omen

Hea$t# cae po!i'es -a) a'!ise /o-en /#o #a!e ec%ent UTIs to t) one o" t#e"o$$o/in( teat-ent options4

• Ta6e $o/ 'oses o" t#e pesci&e' anti&iotic 'ai$) "o 1 -ont#s o $on(e. I"

ta6en at &e'ti-e, t#e -e'ication e-ains in t#e &$a''e $on(e an' -a) &e

-oe e""ecti!e. NIH8s%ppote' eseac# #as s#o/n t#is t#eap) to &e e""ecti!e

/it#o%t ca%sin( seio%s si'e e""ects.

• Ta6e a sin($e 'ose o" an anti&iotic a"te seB%a$ inteco%se.

• Ta6e a s#ot co%se>0 o 'a)s>o" an anti&iotic /#en s)-pto-s appea.

To t) to pe!ent an in"ection, #ea$t# cae po!i'es -a) s%((est /o-en

• 'in6 p$ent) o" /ate e!e) 'a)

• %inate /#en t#e nee' aises an' a!oi' esistin( t#e %(e to %inate

• %inate a"te seB%a$ inteco%se

• s/itc# to a 'i""eent -et#o' o" &it# conto$ i" ec%in( UTIs ae a po&$e-

Infections during !regnancy

D%in( pe(nanc), &acteia$ in"ection o" t#e %ine>e!en in t#e a&sence o" s)-pto-s

 >can pose is6s to &ot# t#e -ot#e an' t#e &a&). So-e anti&iotics ae not sa"e to ta6e

'%in( pe(nanc). In se$ectin( t#e &est teat-ents, #ea$t# cae po!i'es consi'e

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!aio%s "actos s%c# as t#e -e'ication9s e""ecti!eness, t#e sta(e o" pe(nanc), t#e

-ot#e9s #ea$t#, an' potentia$ e""ects on t#e "et%s.

Com#licated Infections

C%in( in"ections t#at ste- "o- a %ina) o&st%ction o ot#e s)ste-ic 'iso'e'epen's on "in'in( an' coectin( t#e %n'e$)in( po&$e-, so-eti-es /it# s%(e). I" 

t#e oot ca%se (oes %nteate', t#is (o%p o" patients is at is6 "o 6i'ne) 'a-a(e. A$so,

s%c# in"ections ten' to aise "o- a /i'e an(e o" &acteia an' so-eti-es "o- -oe

t#an one t)pe o" &acteia at a ti-e.

Infections in .en

Uina) tact in"ections in -en ae o"ten t#e es%$t o" an o&st%ction>"o eBa-p$e, a

%ina) stone o en$a(e' postate>o ae "o- a cat#ete %se' '%in( a -e'ica$

 poce'%e. T#e "ist step in teatin( s%c# an in"ection is to i'enti") t#e in"ectin(o(anis- an' t#e -e'ications to /#ic# it is sensiti!e.

Postate in"ections>c#onic &acteia$ postatitis>ae #a'e to c%e &eca%se

anti&iotics -a) &e %na&$e to penetate in"ecte' postate tiss%e e""ecti!e$). Fo t#is

eason, -en /it# &acteia$ postatitis o"ten nee' $on(8te- teat-ent /it# a cae"%$$)

se$ecte' anti&iotic. UTIs in -en ae "e%ent$) associate' /it# ac%te &acteia$

 postatitis, /#ic# can &e $i"e t#eatenin( i" not teate' %(ent$).

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Ho" can recurrent U$Is *e #reented

C#an(in( so-e 'ai$) #a&its -a) #e$p a peson pe!ent ec%ent UTIs.

Eating/ Diet/ and Nutrition

Din6in( $ots o" "$%i' can #e$p "$%s# &acteia "o- t#e s)ste-. 5ate is &est. Most

 peop$e s#o%$' t) "o siB to ei(#t, 8o%nce ($asses a 'a). A peson /#o #as 6i'ne)

"ai$%e s#o%$' not 'in6 t#is -%c# "$%i'. A #ea$t# cae po!i'e s#o%$' &e cons%$te' to

$ean #o/ -%c# "$%i' is #ea$t#).

Urination Ha*its

A peson s#o%$' %inate o"ten an' /#en t#e %(e aises. 2acteia can (o/ /#en %ine

sta)s in t#e &$a''e too $on(. 5o-en an' -en s#o%$' %inate s#ot$) a"te seB to "$%s#

a/a) &acteia t#at -i(#t #a!e entee' t#e %et#a '%in( seB. Din6in( a ($ass o"

/ate /i$$ a$so #e$p "$%s# &acteia a/a).

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A"te %sin( t#e toi$et, /o-en s#o%$' /ipe "o- "ont to &ac6. T#is step is -ost

i-potant a"te a &o/e$ -o!e-ent to 6eep &acteia "o- (ettin( into t#e %et#a.

Clothing

Cotton %n'e/ea an' $oose8"ittin( c$ot#es s#o%$' &e /on, so ai can 6eep t#e aeaao%n' t#e %et#a '). Ti(#t8"ittin( Geans an' n)$on %n'e/ea s#o%$' &e a!oi'e'

 &eca%se t#e) can tap -oist%e an' #e$p &acteia (o/.

0irth Control

Fo /o-en, %sin( a 'iap#a(- o spe-ici'e "o &it# conto$ can $ea' to UTIs &)

inceasin( &acteia (o/t#. A /o-an /#o #as to%&$e /it# UTIs s#o%$' t) s/itc#in(

to a ne/ "o- o" &it# conto$. Un$%&icate' con'o-s o spe-ici'a$ con'o-s

incease iitation, /#ic# -a) #e$p &acteia (o/. S/itc#in( to $%&icate' con'o-s

/it#o%t spe-ici'e o %sin( a nonspe-ici'a$ $%&icant -a) #e$p pe!ent UTIs.

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!oints to Remem*er

• Most %ina) tact in"ections *UTIs+ aise "o- one t)pe o"

 &acteia, Escherichia coli (E. coli), /#ic# no-a$$) $i!es in t#e &o/e$.

• S)-pto-s o" a UTI in a'%$ts -a) inc$%'e t#e "o$$o/in(4

o a "e%ent an' intense %(e to %inate

o a pain"%$, &%nin( "ee$in( in t#e &$a''e o %et#a '%in( %ination

o "ee$in( tie', s#a6), an' /ea6 

o -%sc$e ac#es

o a&'o-ina$ pain

o on$) s-a$$ a-o%nts o" %ine passe', 'espite a ston( %(e to %inate

o c$o%'), 'a6, o &$oo') %ine o %ine t#at #as a "o%$ s-e$$

o  pain in t#e &ac6 o si'e &e$o/ t#e i&s

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o na%sea an' !o-itin(

• Fe!e -a) in'icate a 6i'ne) o postate in"ection.

• 2eca%se &acteia can &e "o%n' in t#e %ine o" #ea$t#) in'i!i'%a$s, a UTI is

'ia(nose' &ase' &ot# on s)-pto-s an' a $a&oato) test.

• UTIs ae teate' /it# &acteia8"i(#tin( -e'ications ca$$e' anti&iotics o

anti-ico&ia$s.

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Ho#e through Research

Scientists ae /o6in( on 'e!e$opin( a !accine t#at can pe!ent UTIs "o- co-in(

 &ac6. Reseac#es ae testin( inGecte' an' oa$ !accines to see /#ic# /o6s &est.

Anot#e -et#o' &ein( consi'ee' "o /o-en is to app$) t#e !accine 'iect$) as a

s%pposito) in t#e !a(ina. Ot#e scientists ae /o6in( on i'enti")in( /a)s to pe!ent

UTIs %sin( po&iotics.

Paticipants in c$inica$ tia$s can p$a) a -oe acti!e o$e in t#ei o/n #ea$t# cae, (ain

access to ne/ eseac# teat-ents &e"oe t#e) ae /i'e$) a!ai$a&$e, an' #e$p ot#es &)

conti&%tin( to -e'ica$ eseac#. Fo in"o-ation a&o%t c%ent st%'ies,

!isit ///.C$inica$Tia$s.(o!.

?Top@

1or .ore Information

American Urological Association 1oundation

JJJ Copoate 2o%$e!a'

Lint#ic%-, MD 0JJ

P#one4 JJ011 o J1JJ

FaB4 J1

E-ai$4 a%a"o%n'ationa%a"o%n'ation.o(

Intenet4 ///.Uo$o()Hea$t#.o( 

$he !rostatitis 1oundation

J1 Jt# Steet, 2oB

S-it#s#ie, IL 1

P#one4 0JJ

FaB4 J0

http://www.clinicaltrials.gov/mailto:auafoundation@auafoundation.orghttp://www.urologyhealth.org/http://www.clinicaltrials.gov/mailto:auafoundation@auafoundation.orghttp://www.urologyhealth.org/

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E-ai$4 MCapstoneao$.co-

Intenet4 ///.postatitis.o( 

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Acno"ledgments

P%&$ications po'%ce' &) t#e C$eain(#o%se ae cae"%$$) e!ie/e' &) &ot# NIDDK

scientists an' o%tsi'e eBpets. 2ets) FoB-an, P#.D., Uni!esit) o" Mic#i(an Sc#oo$

o" P%&$ic Hea$t#, an' Ant#on) Sc#ae""e, M.D., Not#/esten Uni!esit) Me'ica$

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In"o-ation 5a)

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