Mediaplanet sat down with Malcolm Thaler, MD, One Medical Group, for his medical insight on common questions surrounding the urinary tract. 

Mediaplanet: First of all, what is the urinary tract?

Malcolm Thaler: The urinary tract consists of all the anatomic structures of the body that participate in the creation of urine. These include the kidneys, ureters, bladder and urethra. The kidneys filter the blood, removing waste products that result from the body’s complex metabolic processes. This filtrate is the urine, and as it passes through the kidney on its way out of the body it is refined, concentrated, and adjusted through many complicated biologic processes. The product of all this activity—the urine—passes down the ureters, is stored in the bladder, and is eventually excreted through the ureters.

MP: What are the symptoms of a urinary tract infection (UTI) or bladder infection?

MT: Urine is normally sterile, but bacteria on the skin, in the vagina, or in the GI tract can enter the urinary system and infect it. The most common pathogen is E. coli, but there are many others that can cause urinary infections.

The most common symptoms of a UTI are:

  • Burning or pain when you urinate
  • Pain in the lower abdomen or pelvis
  • An urge to urinate more frequently, although when you do go to the bathroom very little urine may come out
  • Cloudy, foul-smelling or bloody urine

When these are the only symptoms, the infection is usually confined to the lower urinary tract, primarily the bladder. If, however, you also have fever (greater than 100.4 degrees F), nausea, vomiting, or pain on one or both sides of the low back, then the infection may have ascended up the ureters or the kidneys.

MP: Why do women seem to get more UTIs than men?

MT: The reason is simple: The bacteria that live on a woman’s skin have only a short distance to travel to get to the bladder. Women have a much shorter urethra than men, plus the urethra itself is closer to the rectal opening, a common source of the bacteria that cause UTIs. This also explains why women often wake up with UTIs after sex—all that activity can move these bacteria right up to and into the urethra.

MP: What should I do if I think I have a UTI?

MT: See your health care provider. The diagnosis can usually be confirmed with a simple urine dipstick that tests for bacteria and white blood cells (inflammatory cells that are part of the body’s natural response to the infection) in the urine. A positive dipstick in combination with typical symptoms is almost always sufficient to make the diagnosis. Your health care provider will also check your temperature and examine you to make sure you have a bladder infection and not an infection that has extended to the kidneys.

MP: I’ve done everything I can but still get a several UTIs every year; should I be worried?

MT: I can’t think of any medical condition made better by worry! However, in this case there truly is no need for concern. There is no evidence that even frequent recurrences lead to chronic kidney disease or other conditions where the kidneys may play an important role, such as high blood pressure. Obviously, if there is some underlying physiologic or anatomic problem with the kidneys predisposing to recurrent infection, that’s a different story, but such situations are very, very uncommon.