By Dr. Dana Rice
You have a tingly sensation on the tip of your bits. And the weird urge to pee — despite having just gone — discomfort and burn from the few pathetic drops you do release (even though you SWORE you actually had to go this time). You zip up your pants and wait for the stinging and itching and throbbing to subside for minutes that feel like a lifetime, and you realize— you’ve got a UTI.
Urinary Tract Infections, or UTIs, are extremely common afflictions that affect people of all genders. It’s a burning, itching, painful fact of life that unites people of all genders. We’ve all had our run-ins with UTIs (if you haven’t — I hate you), but do we really understand them? We asked Dr. Dana Rice, founder of UTI tracker, our ~burning~ questions.
What causes a UTI?
A urinary tract infection by definition is caused by a bacterial or fungal organism. There are formal definitions of colony counts and frequent organisms associated with UTIs, but I think it is important to note that it is possible to have all the “symptoms” of a UTI that do not fall into the classic definitions.
Many people use "UTI" to describe feelings of discomfort when urinating. Urinary tract infections however are much more complicated. In fact, many women with have asymptomatic UTIs, or in other words bacteria in the bladder that does not cause any symptoms.
What most people call "UTI" is generally the feeling of burning while urinating, urinary urgency and overall discomfort in the suprapubic region. If these symptoms are caused by a bacteria, it is actually a symptomatic bacterial cystitis. This means a bacteria is causing a bladder infection.
Please keep in mind that there are other genital infections, hormonal fluctuations and topical irritants that may cause similar symptoms that are not bacterial cystitis. In addition, there are also other types of urinary tract infections that do not cause bladder symptoms, ie. kidney infections.
As you can see, answering questions about UTIs is not as straightforward as one may think. For the purpose of this article, when I use “UTI” it will be referring to acute bacterial cystitis — or the “burning, stinging, hurts-when-you-pee” infection.
How can you recognize the symptoms versus another type of infection? (i.e. a yeast infection or BV?)
Each type of genital infection has classic signs and symptoms, but not everyone has the same presentation. It is very easy to confuse UTIs with other irritative symptoms or infections.
The gynecological questions get to be a bit dicey. Common symptoms of gyn problems are usually vaginal discharge and/or odors. UTIs can cause a foul smell in the urine, but there are certain foods that can alter the smell of urine as well, hello asparagus. Strange or foul smelling urine is not necessary a bacterial UTI that needs to be treated.
Tracking symptoms of urgency and frequency is also quite helpful. Some women will experience these symptoms mid-cycle. In these cases, the symptoms may be related to pressure from the uterus as opposed to a bladder infection.
After intercourse some people may have burning with urination as well. While this may be the start of a UTI, it may also be urethral irritation from friction. Keeping logs and records are often helpful to determine what is a symptom of a true UTI vs other problems in the area.
What is your best course of treatment if you can feel a UTI coming?
I recommend drinking plenty of water, timed voiding and considering over the counter supplements like AZO for pain and D-Mannose. It is also important to make sure urine is cultures prior to starting antibiotics.
It is important to make sure that a urine culture is sent prior to starting antibiotics. A culture allows for individual organisms to be identified. It also checks what types of antibiotics can treat the bacterial organisms. It is very common for patients to have bacteria resistance (certain antibiotics can't treat your infection), so knowing what organism is growing in your urine is a good thing. That way the right medication can be used to treat the infection.
Is there any truth to cranberry juice?
Controlled trials have shown that cranberry juice does not help prevent UTIs. There are supplements with high concentrations of extract that are more effective than placebo. D-Mannose has been tested as well with good efficacy studies.
What other home remedies do you wish people would stop using?
I do not encourage any feminine hygiene washes or douches. I have also heard of people drinking baking soda. This can be dangerous, so I wish this would be removed from internet UTI home remedy sites.
One of the major concerns of consuming too much baking soda can be electrolyte abnormalities, and ingesting too much baking soda at once can induce vomiting, diarrhea, and can even result in seizures, dehydration, and kidney failure.
Are there certain conditions that make you more susceptible to a UTI?
There are congenital anomalies that people are born with that make them more susceptible. For example, vesicoureteral reflux is when urine from the bladder can be pushed up (refluxed) back into the kidney.
Hormonal states, menopause changes and birth control, can play a role in increased risk.
Can you transfer a UTI to a partner?
Short answer: Kind of.
Long answer: There are sexually transmitted infections that can be spread between partners that may cause UTI-like symptoms, however in women many of these infections will also cause vaginal discharge, burning or pelvic pain. Mycoplasma is a bacterial organism that can often given UTI symptoms and not grow on common urine cultures. It is an organism that can be easily treated and often relieves UTI symptoms, but patients will return to a clinic if their partner was not treated.
Are only people with vaginas susceptible to UTIs?
There are medical conditions that predispose men to UTIs as well, specifically BPH (benign prostatic hyperplasia) to name one. However, the female urethra is shorter than a male urethra — means less distance for bacteria to travel from the opening to the bladder —so it is an inherent risk.
Why do some people get UTI’s more frequently than others?
Excepting birth defects or other explainable causes, science does not give us a great way to discern who is at risk for frequent UTIs. To name a few common things I run into are:
Incomplete emptying
Dysfunctional voiders (constipation, holding urine, etc)
Hormone imbalances
Kidney stones
How can you prevent repeat UTI’s if you frequently get them?
I created the UTI Tracker App to help patients answer this exact question. First, you must get urine cultures to help determine what bacteria or organisms are giving you your symptoms. Then once you know if it is a true UTI or urgency and frequency without bacterial infection, then you can focus on triggers. Most patients will have some trigger for their symptoms, ie. intercourse, holding bladder too long, menstruation, diarrhea, etc.
Once you can narrow down your triggers then you can work on prevention strategies, timed voiding, good bowel habits, increased water intake are just a few tricks. In addition, if you know your infections are caused by E. Coli for example, then you would be a good candidate for D-Mannose supplement. Other supplements and options for prevention are available. It just starts with learning your body.
The UTI Tracker app features an educational center to help inform
patients about management of UTIs and UTI-like symptoms. It includes prevention
strategies, weekly helpful hints, detailed symptom tracking and an electronic voiding
diary. It also enables patients to track their medication and culture results to share moreeasily with future health care providers.
Dr. Rice was named a top doctor in the Washingtonian Magazine and Northern Virginia
Magazine. She’s been featured in Cosmo, Buzzfeed, Romper, E Health Radio, Northern
VA Magazine and on Ashley Iaconetti’s Podcast, among others. You can download the
app in your Apple Store and on Google Play
Have other pee probs?
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Dana C. Rice, MD is a board certified urologist in the Washington, D.C. area. She completed her medical studies and her postgraduate residency at George Washington University. She has co-authored a chapter on urinary tract infections and developed her UTI Tracker app to help educate patients and physicians. She resides in Mclean, VA and maintains a very busy surgical practice as well as being a wife and mother of two young children.
www.utitracker.com | @UTITracker
@Dr_DanaRice
