Understanding Urinary Tract Infections Across the Lifespan

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.

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.

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. 

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. 

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.