Understanding Urinary Tract Infections Across the Lifespan

Urinary tract infections (UTIs) are very common in the U.S. In fact, UTIs are the second most common type of infection in the body and are the reason for more than 8 million visits to the doctor each year. About 10 in 25 women and 3 in 25 men will have symptoms of a UTI during their lifetime. A UTI happens when you get an infection in your urinary tract. 

Most UTIs are not serious, but some can lead to serious problems like kidney infections. The most common care or treatment for a UTI is antibiotics. Signs of a UTI involve pain or burning when you pass urine, urine that looks cloudy or smells bad, pressure in your lower stomach, and an urge to go to the bathroom often. You can get a UTI at any age, but there are peak times in life when they are more common. Let’s explore UTIs across the lifespan!

UTIs in Children 

Roughly 2.5% of all children will get a UTI. UTIs are most common in children under the age of 5 years. Girls are more likely than boys to get a UTI. If a UTI or other urinary problem keeps occurring with your child, your doctor may send you to a pediatric urologist. Urologists are doctors who are trained to work on problems of the male and female urinary tract, as well as male reproductive organs such as the prostate. A parent can help lower the risk that their child will get a UTI by making sure they stay hydrated. It’s also important to go over or teach good ‘toileting habits’ with kids, such as going to the bathroom often and making sure they don’t hold their urine.

UTIs in Girls and Women

During puberty, young women may get UTIs. This peak in UTIs is often linked to the onset of sexual activity. One more peak time for UTIs in women is after menopause. This is because of lower vaginal estrogen levels. Lower estrogen levels make it easier for bacteria to grow. Much like girls having higher rates of UTIs than boys, women have higher rates of UTIs than men because of their anatomy. A woman’s urethra is shorter than a man’s. This makes it easy for bacteria to enter her bladder. To add to the human body make-up, the opening of a woman’s urethra is near the anus and vagina/birth canal; two common places where bacteria dwell. To help stop UTIs before they happen, women are urged to wipe from ‘front to back’ when using the bathroom. This helps cut the chance of spreading bacteria from the anus to the opening of the urethra.

Women may also notice more UTIs after sexual activity. “For patients who experience this issue, taking a low dose antibiotic taken around the time of sexual activity can be very useful in lowering the overall rate of infection,” says Dr. Tomas Griebling, professor of urology at the University of Kansas School of Medicine.

UTIs in Older Adults

Older men (such as, men 70 years and older) are at somewhat higher risk for UTIs because of problems going to the bathroom and/or emptying the bladder. Older post-menopausal women are also at a greater risk for UTIs due to lower amounts of vaginal estrogen, which can change the vaginal climate. The normal flora, ‘good bacteria,’ are looked at as ‘good’ because they kill off other types of bacteria that can cause UTIs. Good bacteria can only grow in slightly acidic vaginal climates and this needs some estrogen. Systemic estrogen replacement options like pills and skin patches do not help with this problem, but vaginal estrogen therapy can be helpful for certain individuals. Talk to your doctor to see if this is a choice for you. 

Often, older adults can help stop UTIs by staying hydrated, using the bathroom and getting routine health exams to screen for health problems like high blood sugar that puts you at higher risk for getting a UTI. If you or a loved one wears adult diapers, it’s very important to keep the genital area clean and to change them often. 

Other Groups at High-Risk for UTIs

People with high blood sugar and vesicoureteral reflux are at higher risk of getting a UTI. Vesicoureteral reflux is when urine goes backwards from the bladder toward the kidney. Over time, this reflux of infected urine may raise a person’s risk for kidney damage. Vesicoureteral reflux is usually seen in children with UTIs compared to adults. Additionally, some patients with kidney stones and indwelling catheters may also be a higher risk for getting a UTI. An indwelling catheter is a hollow tube that is placed into the bladder through the urethra and left inside your body. The catheter drains urine from your bladder into a bag outside of your body. A catheter-associated UTI happens when bacteria enter the urinary tract through the catheter and cause an infection.Often, older adults can help stop UTIs by staying hydrated, using the bathroom and getting routine health exams to screen for health problems like high blood sugar that puts you at higher risk for getting a UTI. If you or a loved one wears adult diapers, it’s very important to keep the genital area clean and to change them often. 

The purpose of your urinary tract is to make and store urine. Your urinary tract is made up of two kidneys that make urine, a bladder that holds urine, two ureters (the tubes that carry urine from the kidney to the bladder) and a urethra (the tube that carries urine from your bladder out of your body).

How UTIs are Diagnosed

In most cases, if you think you have a UTI, you should visit a health care provider and give a urine sample for testing. A urinalysis is a test that looks for white blood cells, red blood cells, bacteria, and or other chemicals such as nitrites in your urine. A proper urinalysis can pinpoint an infection and a urine culture can help your health care provider choose the best antibiotic for treatment. It is vital to get a urinalysis and culture performed to make sure you have an infection and require care. Use of antibiotics when not needed, can be tricky, and can lead to greater rates of bacterial antibiotic resistance. 

It should be noted that some individuals get a urinalysis result that shows bacteria, but the individuals are not having any symptoms of a UTI. This event is common in older adults. If the individual has bacteria in their urine, but has no symptoms, treatment is not right. Treatment should be given to individuls who have bacteria and associated UTI symptoms.  

In closing, it should be noted that studies on cranberry juice and linked supplements are mixed. Some studies show that cranberry supplements can be helpful and other studies show that they don’t help stop UTIs before they happen. Be sure to read about the pros and cons of cranberry products, and decide if they’re right for you. For now, practice these tips to lower your risk of getting a UTI. 

Tips for Preventing UTIs

  1. Drink plenty of water.
  2. Urinate often.
  3. Don’t hold it.
  4. Keep your genital area clean.
  5. Empty your bladder before and after sex

For more information about UTIs in men, women and children, visit UrologyHealth.org.

UrologyHealth.org  |  SUMMER 2016  |  UROLOGYHEALTH extra