What Women — and Men — Need to Know About UTIs

A urinary tract infection, or UTI, is an infection in any part of the urinary system. While the bladder and urethra (the passageway between the bladder and the external part of the body) are the most common locations for infections, they can also affect the kidneys and ureters (the tubes connecting the kidneys to the bladder). Women are more susceptible to UTIs than men, mainly due to their anatomy. The female urinary system places the anus (a source of the most common bacteria to cause UTIs) in close proximity to the urethra. The urethra is the entry point to the urinary system. The distance from the urethral opening to the bladder is also relatively short in women. This makes the journey for troublesome microorganisms an easy one.

The Circumcision/UTI Connection

Men are far less likely to develop UTIs than women, however, infections are not unheard of, especially for males who have not been circumcised. Circumcision is the surgical removal of the foreskin, a retractable fold of skin that covers the end of the penis. Studies show that male infants who haven't been circumcised are 9.9 times more likely to develop a UTI before the age of one than baby boys who have had their foreskin removed. The prevalence lessens as males mature, but adult men are still more likely to develop a UTI if they have not been circumcised. As in the case of women, anatomy is the culprit. It's easy for bacteria to accumulate under the foreskin and even the most attentive hygiene may not fully eradicate harmful microbes.

Risk Factors

In addition to the issues listed above, several factors can increase the risk of developing a UTI.

• Sexual activity
• Diaphragms and spermicidal agents: Diaphragms press against the urethra preventing the complete emptying of the bladder. Spermicides may interfere with the "good" bacteria in the vagina. This creates an opportunity for the more troublesome varieties to set up a home and migrate to the urinary tract during sex.
• Menopause: The decline in estrogen causes changes to the lining of the vagina and urinary tract, increasing vulnerability.
• Urinary tract abnormalities that don't allow urine to leave the body normally or cause it to back up in the urethra
• Blockages in the urinary tract (i.e., kidney stones, enlarged prostate)
• A suppressed immune system decreases the ability to combat invading microorganisms.
• Catheter use: The tubing that is inserted into the urinary tract provides a pathway for bacteria to enter.

Signs and Symptoms of a UTI

While some UTIs do not offer any warning signs, the following symptoms are indicators that something is amiss and a trip to your health care provider may be in order.

• Strong, constant urge to urinate
• Burning sensation when urinating
• Passing frequent, small amounts of urine
• Urine that appears cloudy
• Urine that appears red, bright pink or cola-colored (a sign of blood in the urine)
• Strong smelling urine
• Pelvic pain in women

Prevention of Urinary Tract Infections

Despite any vulnerabilities you may or may not have, there are steps you can take to prevent bacteria from entering your urinary tract and flushing it out before it starts trouble.

• Drink plenty of fluids, especially water. Regular fluid intake dilutes urine and triggers more frequent urination, which flushes bacteria from the system.
• Cranberry juice. The debate continues as to whether or not cranberry juice affects the urinary tract. Studies are not conclusive, but it's not harmful so, unless you have diabetes, it's OK to include cranberry juice in your diet.
• Wipe from front to back after urinating and bowel movements. The practice helps keep bacteria away from the urethral opening and vagina.
• Empty your bladder just before and after intercourse to flush out any bacteria that may have migrated from other areas.
• Avoid feminine products that may irritate the area, such as deodorant sprays, douches, powder, and scented pads or tampons.
• Consider changing your birth control method if you use a diaphragm and/or spermicide.
• Avoid holding your urine so that bacteria don't have a chance to set up shop in your bladder.
• Wear cotton underwear to promote air circulation in the vulnerable area.
• Change out of wet clothes or swimsuits ASAP. Bacteria like a warm, moist environment.

As with all health care concerns, your provider is one of your best allies in treating and preventing urinary tract infections. Initiating a conversation about problems "down there" can feel awkward, but remember your care team is made up of trained professionals who have heard it all before. If you have any questions or are experiencing any symptoms, don't hesitate to initiate a conversation. Related: Urinary Incontinence: The Leak of Which We Don't Speak Take a Pass on Annual Pelvic Exams