Infections of the urinary tract are the most common reason for urologic evaluation. They can range from simple, uncomplicated infections of the bladder (cystitis) to more serious kidney infections (pyelonephritis) associated with high fever and requiring hospitalization.

Symptoms of urinary tract infection (UTI) may include frequent urination, burning on urination (dysuria) or urinary urgency. Patients may urinate often but only pass a small amount of urine and may not feel they empty completely.

A urine culture should be obtained to confirm a diagnosis of UTI. If a quality specimen cannot be obtained by voiding, a patient may have to be catheterized to collect the urine for culture. The culture result will include a list of antibiotics to which the infection is sensitive and/or resistant.

The color and odor of the urine are not reliable or useful indications of infection.

Simple infections are usually treated with 3 to 5 days of antibiotics. Complicated or recurrent infections may require longer treatment and may require further evaluation of the urinary tract. In cases of prostate infection, antibiotics are commonly prescribed for 4 to 6 weeks.

The most serious infections are associated with high fever and/or a urinary obstruction such as occurs with a kidney stone. These infections are life-threatening and require immediate evaluation and treatment usually in a hospital setting.

Recurring UTI's are often seen in patients with diabetes or other chronic diseases. In these instances, the use of low-dose suppressive antibiotics may reduce the frequency or severity of infections.
Urinary Tract Infections
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Steven A. Johnson, M.D.