Myths and truths about urinary tract infections

Christina Frangu 19 August 2021

There are so many misconceptions about UTI's, so read on to see them dispelled

Urinary tract infections can make some people, particularly women, feel needlessly ashamed. “For years, women were told that UTIs were related to their cleanliness, but they’re not,” says Dr. Barbara W. Trautner, physician at Houston’s Michael E. DeBakey VA Medical Center and a professor at Baylor College of Medicine.

It is true that women get UTIs far more frequently than men, but it’s a matter of anatomy, not hygiene. For anyone, a UTI develops when bacteria in the bladder—usually introduced via the urethra—cause inflammation or other symptoms somewhere along the urinary tract. Since a woman’s urethra is shorter than a man’s, the bacteria have less distance to travel to reach the bladder. As well, in women’s bodies the urethra opening is closer to the anus, where E. coli, a common cause of UTIs, reside.

Another possible misconception about UTIs is that they cause delirium in seniors. Trautner says the evidence around that isn’t conclusive. A fever related to a UTI could be a contributing factor, but the delirium is more likely to be a symptom of an underlying brain disease, taking multiple medications, malnutrition, untreated pain, or organ failure. Making things even more confusing, Trautner adds, is the fact that bacteria are often present in the urine of older adults without causing harm—a condition known as asymptomatic bacteriuria, which normally requires no treatment.

"Bacteria are often present in the urine of older adults without causing harm—a condition known as asymptomatic bacteriuria, which normally requires no treatment"

UTIs do become more common with age, however, for both men and women. In women, estrogen levels drop after menopause and the vagina loses protective bacteria that keep harmful bacteria out. In men, the prostate begins to enlarge after age 50, and can trap urine in the bladder. Also, all older adults are more likely to acquire risk factors such as kidney stones, catheter use, or a suppressed immune system from diseases like diabetes.

Determining whether you have a UTI depends on where the infection is located. In the lower parts of the urinary tract, such as the bladder, symptoms are related to urinating: an urgent need to go, burning while urinating, blood in the urine, or pain in the pelvic region. On the other hand, an infection that affects the kidneys is known as an upper urinary tract infection, and the symptoms are more vague, consisting of back and flank pain, high fever, vomiting, nausea, or chills.

"Determining whether you have a UTI depends on where the infection is located"

Antibiotics are the recommended treatment for UTIs, but there’s a high risk of recurrence, especially among women. If this happens , it’s not the patient’s fault, says Dr. Larissa Grigoryan, an assistant professor of family and community medicine at Baylor. “In some cases, it’s due to increasing antibiotic resistance,” she says, explaining that physicians will then prescribe another course of that antibiotic or try a different one.

Can cranberry juice help? It’s long been believed that it can prevent or cure UTIs.

Cranberry juice

While some research shows that an active ingredient in cranberry juice can prevent bacteria from sticking to the bladder wall, larger studies have not confirmed a benefit. But even if cranberry juice is not a fix, it’s not harmful. In fact, drinking plenty of non-alcoholic fluids is a good prevention strategy. In a 2018 study published in JAMA, women who increased their regular intake of fluids by 1.5 litres each day were less likely to get a UTI.

So, to keep these infections at bay, the best prevention strategy is simple: drink water and empty your bladder often. 

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