Employee & Community Health

True or false: Test your UTI savvy

3/19/2018 by Dr. Henry Schultz

ECH_UTI_widget

How savvy are you when it comes to urinary tract infections (UTIs)? Take this quiz to find out — and learn more about what causes UTIs and how to treat and prevent them. 

True or false: We don't really know what causes a UTI.

False. A UTI is a bacterial infection of the lining of your bladder that causes the lining to become irritated and inflamed. E. coli bacteria, which lives in your intestinal tract and comes from your own bowel, is the culprit in 90% of UTIs. Some women seem to be more susceptible to these infections. 

True or false: A UTI can indicate the onset of sexual activity.

True. Typically, the chance of developing a UTI increases after you start having intercourse. E. coli that colonizes in your urinary/genital area can be pushed into your urethra and bladder during sexual activity. 

True or false: Itching is one of the main symptoms of a UTI. 

False. Itching is NOT a UTI symptom. If you experience an urgent, frequent need to urinate, don't produce much urine despite that urge and have an internal burning sensation when you go, you have the symptoms of a UTI and should contact your care team. 

True or false: It's important to go to the clinic for a urine culture to diagnose if you have a UTI.

False. We now recommend that you call your primary care team's appointment line. They can connect you with a nurse who will walk you through your symptoms. If your symptoms indicate an uncomplicated UTI (no sexually transmitted disease or kidney problem), they can prescribe an antibiotic over the phone. Antibiotics have been proven effective in more than 90% of cases. You may be prescribed one such as nitrofurantoin (Macrodantin, Macrobid) or fosfomycin (Monurol). 

True or false: Drinking cranberry juice helps if you are having symptoms of a UTI. 

False. Years ago, a small study suggested that drinking large amounts of cranberry juice would increase the acidity level in your urine, killing harmful bacteria and preventing UTIs. Since then, a number of studies have debunked this. Cranberry products do not reduce the occurrence of symptoms, nor do they help once acute symptoms have started. 

True or false: Being a "goer" rather than a "holder" protects you from UTIs.

True. When you feel the urge to go you should head to the bathroom. Holding urine in your bladder for extended periods of time provides fertile ground for infection. Two other techniques that can prevent UTIs are: 

  • Emptying your bladder and drinking a glass of water after intercourse. 
  • For post-menopausal women, applying topical estrogen cream, prescribed by your provider, can significantly reduce the incidence of UTI. 

If you have three or more UTIs a year, in addition to the steps above, your care team may prescribe a very small dose of antibiotic to take after intercourse or three times a week. Having a complete urological evaluation is not necessary; it's better to be on a preventative program. 

True or false: Only women get UTIs.

False. Men also can get the infections, but they occur much less frequently and tend to be more complicated. 

True or false: A UTI in the elderly can cause behavioral and cognitive changes.

False. Multiple studies have shown there is no link between UTIs and changes in behavior, confusion, dementia or falls. So how did these two come to be connected? 

Many elderly carry bacteria in their urine, without symptoms of infection, especially those who have cognitive impairment, urinary incontinence or are living in long-term care facilities. If caregivers notice behavioral or cognitive changes, a urine culture might be performed. 

When the elderly have cognitive issues, they have good days and bad days. If they're given an antibiotic on a bad day, as they swing toward their good days, it's assumed the antibiotic eliminated the infection and improved their mental state. And that's how a misconception was born. 

Unfortunately, it also gave birth to prescribing unneeded antibiotics, which can be a huge concern if the person develops a challenging infection, such as C. difficile. There's now a major push to educate health care professionals and caregivers about this issue. 

The message: Unless a person has symptoms of a UTI — urgent, frequent need to urinate, little urine production when they go and a burning sensation — they should not undergo a urine culture or be treated with antibiotics. 

Dr. Henry Schultz is a primary care physician in Employee and Community Health's (ECH) Division of Primary Care Internal Medicine (PCIM) in Rochester. In addition to primary care, he also is dedicated to educating future physicians and has received Mayo Clinic Department of Medicine's Lifetime Achievement Award for Medical Education.