The Condition

Urinary tract infections (UTIs) are common infections that affect the lower urinary tract (Bladder and Urethra) or the upper urinary tract (Kidneys). About 10 in 25 women and 3 in 25 men will have symptoms of UTI during their lifetime.

What is a UTI?

A urinary tract infection (UTI) can affect any part of your urinary system.

UTIs that affect your bladder or urethra (lower urinary tract) can be uncomfortable or painful and usually pass within a few days to a week, after being treated with antibiotics. This is also known as ‘cystitis’, which is the most common urinary tract infection affecting about half of all women in their lifetime.

However, a UTI can be much more serious if it spreads to your kidneys (upper urinary tract). This is also known as ‘pyelonephritis’ and usually makes the sufferer feel quite unwell. Kidney infection can sometimes lead to blood stream infection also known as ‘urosepsis’ and this is a serious condition. It requires a more powerful antibiotic treatment, and requires hospital admission for intravenous antibiotics.

What are the symptoms of urinary tract infections?

The symptoms experienced by somebody who has UTI may include:

• pain such as burning or stinging when weeing, pain in your lower belly or lower back
• more frequent urination
• urgency to urinate (and possibly some leakage)
• difficulty passing urine with slow stream and incomplete emptying of the bladder
• visible blood in your wee
• waking up to wee several times during the night
• wee that looks cloudy, dark or has a strong smell
• fever, chills, rigors, nausea, vomiting and Loin (flank- upper back) pain

The location of pain can vary significantly, but may be focused in the lower belly and lower back, loins (upper back), urethra and genitalia.

Other symptoms associated with urinary tract infections including malaise, lethargy, foggy head, balance, memory problems and generalised body and joint aches.

When the symptoms of UTI do not resolve or recur despite standard antibiotic treatment, they are classified as follows:

Recurrent UTI (rUTI)

• Two or more infections within six months, or three or more infections within one year with no lower urinary tract symptoms between the episodes.

Chronic UTI (CUTI)

• Persistent or continuous painful lower urinary tract symptoms which do not respond to standard antibiotic treatment. The symptoms are almost continuous, varying in severity from day to day, extremely bothersome and affecting a patients daily life, work or activity.

Interstitial cystitis (IC) / Bladder pain syndrome (BPS)

• Persistent lower urinary tract and cystitis symptoms with no evidence of infection on standard testing.

In our experience, over 90% of patients who present to our service come with a previous diagnosis of IC/BPS. Our testing using fresh urine microscopy shows that they in fact have evidence of a Chronic urinary tract infection missed on standard UTI tests and they recover with treatment targeted at the infection.