Dysuria (“It hurts when I pee”)

Any woman who has had a urinary tract infection (UTI) knows just how uncomfortable and sometimes seriously painful they can be. So it is no surprise to me when I get a call asking for antibiotics from a woman who has started developing the signs and symptoms of a UTI. I get it. You want to stop it before it gets out of control and really starts to hurt. I usually oblige with this request because I have had a UTI before too and it is seriously no fun.

What is a UTI?

A urinary tract infection is a bacterial infection that can travel anywhere within the urinary system which extends from the bladder up to the kidneys. A simple UTI is called cystitis which means the infection is only in the bladder. When the infection ascends into the kidneys then it is a more severe infection of the urinary system called pyelonephritis.

Why did I get a UTI?

The causes of a UTI are numerous but some of the more common causes are as follows:

• Wiping the wrong way: you know it is always front to back, right?

• sex: yep, that is right, sex can cause a UTI. Make sure you urinate after you have sex to lower your chances of a UTI

• vaginal atrophy (dryness): Menopause is a time to develop this condition and can create an environment that makes the urethra (opening to the bladder) more susceptible to infection.

• pregnancy: A pregnant woman is at an increased risk of a UTI in pregnancy due to the pressure that the enlarging uterus places on the urinary system. Also, the symptoms of a UTI are not as noticeable during pregnancy which makes a pregnant woman at risk for a more severe infection of the urinary system called pyelonephritis.

• Difficulty emptying the bladder: as women's bodies change after childbirth and/or age the bladder can struggle to do its job well. Some women cannot empty their bladders completely and the residual urine that is left behind is at risk of infection over time.

What does a UTI feel like?

The symptoms of a UTI include pain with urination (it burns!), hesitancy to urinate, an urgency feeling, spasms/cramps in the bladder and a foul odor can sometimes be noticed. Don't be alarmed if you see blood because that can happen too!

When the infection ascends into your kidneys (pyelonephritis) you will feel pretty sick with fever/chills, nausea/vomiting and back pain.

Treatment

The good news is that a simple UTI is easily treated with antibiotics. Drinking a lot of water is helpful to flush out the bacteria. But please don't start drinking a lot of cranberry juice when you start to get symptoms of a UTI! It wont help and may even hurt because bacteria love sugar and there is a lot of sugar in juice!

If you have pyelonephritis there is a chance you may need to be admitted to the hospital for IV antibiotics. And honestly, you won't mind the hospital admission because you will fell pretty terrible.

The good news is that after 2-3 days of antibiotics the UTI is usually resolving and you are feeling better!

So..... this brings me back to why I prescribe antibiotics to a woman who starts complaining of UTI symptoms? Because antibiotics work fast to treat a simple UTI and prevent a more severe infection.

Ideally, a woman should leave a urine sample at the office so that it can be sent for culture. This way we ensure we are treating you for a UTI and we know that we have treated you with the appropriate antibiotic.

If you are a woman who doesn't have the time to drive to the office and leave a urine sample then I will most likely give you a short course of antibiotics because I want to help you and make you feel better. But I warn all my patients that if you DO NOT feel better in a couple of days then we may be treating you with an ineffective antibiotic. OR..... you may have never even had a UTI and you may have something else that is mimicking the signs and symptoms of a UTI.

That is right ladies..... there are other things out there that may trick you into thinking you have a UTI and that all you need is a few days of antibiotics from your doctor. Well, if those antibiotics are not working to relieve your symptoms then a culture is so important. If the urine culture returns as negative then other causes of your symptoms must be explored.

Wondering what things can disguise themselves into making you think you have a UTI????

• Sexually Transmitted Diseases

• Ureaplasma and Mycoplasma infections

• Kidney stones

• Interstitial cystitis

These areas will be further explored in future posts.

A UTI can be a simple problem with a simple solution. Just remember that even though it is annoying to come to the office to leave a urine sample there are really important reasons we want your pee so badly!