Urinary Tract Infection - Symptoms

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Normally, when the bladder becomes filled, the muscle in the wall of the bladder contracts, and the urine leaves the body via another tube called the urethra. There is a valve-like mechanism where the ureters join the bladder. These valves' job is to keep urine from flowing backward towards the kidneys when the bladder contracts. If the valves do not work well, urine may remain in the bladder where bacteria can grow. The back flow of urine may also carry any infection from the bladder up into the kidneys.

Click the icon to see an image of vesicoureteral reflux.

Institutionalization, Catheterization, and UTI Risk

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Hospitalizations. About 40% of all infections that develop in patients while in the hospital are in the urinary tract. The organisms that cause infections in hospitals (called nosocomial infections) are often different from those that commonly cause UTIs. They are also more likely to be resistant to standard antibiotics. Hospitalized patients at highest risk for such infections are those with in-dwelling urinary catheters, patients undergoing urinary procedures, long-stay elderly men, and patients with severe medical conditions.

Catheters. About 80% of UTIs in the hospital are due to catheters. The longer any urinary catheter is in place, the higher the risk for growth of bacteria and an infection. In most cases of catheter-induced UTIs, there are no symptoms. Because of the risk for wider infection, however, anyone requiring a catheter should be screened for infection. Catheters should be used only when necessary and should be removed as soon as possible.

Nursing Homes. All older adults who are immobilized, catheterized, or dehydrated are at increased risk for UTIs. Nursing home residents, particularly those who are incontinent, are at very high risk.

Medical Conditions that Increase the Risk of UTIs

Diabetes. Diabetes puts women at significantly higher risk for asymptomatic bacteriuria. The longer a woman has diabetes, the higher the risk. (Control of blood sugar has no effect on this condition.) The risk for UTI complications, and fungal-related UTIs, is also higher in people with diabetes.

Kidney Problems. Nearly any kidney disorder, including kidney stones, increases the risk for complicated UTIs.