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UTIs: A Common Woe

A Painful Problem

WebMD Feature
Reviewed by Craig H. Kliger, MD

Nov. 13, 2000 -- Even though it happened more than 10 years ago, Mary Sander still vividly remembers her first urinary tract infection (UTI), when an unimaginable pain wracked her abdomen. "The pain was so bad I thought I was going to die," says Sander, now a 32-year-old clothing designer in Reno, Nev. Medications soon brought comfort. But the agony -- more intense than childbirth, says the mother of four -- remains fresh in her mind.

For Sander, and an increasing number of women in the country, that first infection is just the beginning. Experts from the National Institute of Diabetes and Digestive and Kidney Diseases estimate that UTIs recur in about 20% of all sufferers. And the problem is widespread: Such infections affect 8 to 10 million Americans a year, mostly women, according to the American Foundation for Urological Diseases.

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Since infections tend to recur, many women may need multiple rounds of antibiotics to treat them, says Frank Tally, MD, an infectious disease specialist in Boston. And when women take one antibiotic after another, they may be left with bacteria naturally resistant to all the drugs, he says. However, with the proper precautions, women can help prevent UTIs from occurring in the first place.

Bladder, Kidney, and Pain

What causes a UTI? Doctors point to the bacteria Escherichia coli (E. coli) or Staphylococcus saprophyticus (staph) as the usual suspects. They make their way into the urinary tract, typically through the narrow tube that directs urine out of the body (called the urethra), often encouraged by compressions that tend to occur during sexual intercourse.

The bacteria usually land in the bladder, causing cystitis, the most common type of UTI. This results in pain in and around the pelvis and lower back, as well as a burning sensation when urine -- which could be cloudy, bloody, or foul-smelling -- is passed. Sufferers also tend to have the urge to urinate frequently and usually get up more than once during the night to do so.

If the bacteria migrate higher in the body, from the bladder into the kidneys (through connecting tubes called ureters), women may develop a UTI called pyelonephritis. This causes pain in the middle of the back and often fever and chills.

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