When a UTI Gets Complicated

Medically Reviewed by Melinda Ratini, MS, DO on February 29, 2024
3 min read

Most urinary tract infections -- or UTIs -- are simple and usually easy to treat. When they're treated right away, they rarely lead to serious problems.

But in some cases, a UTI can lead to major issues. If a UTI gets "complicated," it means that regular treatment isn't enough to cure it. Usually, there's some other factor -- maybe an underlying health condition -- that has caused it to get worse. So the usual treatment of 2 to 3 days of antibiotics may not be enough to help you get better and you may need a course of antibiotics designed specifically for treating a complicated UTI.

Here's a look at some of the most common ways that a UTI can get complicated and how they might be treated:

Women who have repeated infections. When you get UTIs over and over, your doctor may suggest a different treatment plan. This might mean taking daily medications for six months or longer, taking a single dose after sex, or taking them for 2 to 3 days when symptoms show up. You might also consider drinking plenty of water, switching birth control methods, and peeing more often, especially right after sex. If you have a severe urinary tract infection, you may need antibiotics by vein. 

Permanent kidney damage. If you don't treat a UTI, a long-lasting kidney infection can hurt your kidneys forever. It can affect the way your kidneys function and lead to kidney scars, high blood pressure, and other issues. Sometimes it can even be life-threatening. You'll take antibiotics to treat a kidney infection. If your symptoms include a high fever and severe pain or you can't keep down fluids, you might also be put in the hospital until your infection has cleared up.

UTIs and diabetes. Women with this condition have a higher risk of complications when they get a UTI than those without diabetes. The key is to diagnose and treat UTIs right away to avoid problems such as kidney infections.

UTIs and pregnancy. These infections are very common during pregnancy. If they’re not treated, they could lead to problems for both mom and baby. This could include a greater risk of delivering a low birthweight or premature baby. Your risk for high blood pressure and anemia also goes up.

Life-threatening infection. If a UTI isn't treated, there’s a chance it could spread to the kidneys. In some cases, this can trigger sepsis. This happens when your body becomes overwhelmed trying to fight infection. It can be deadly. Symptoms include extreme pain and issues with body temperature, heart rate, respiratory rate, and white blood cell count.

UTIs in men. These infections are less common in men than in women. They usually happen because of some kind of blockage. This may be due to an enlarged prostate, a urinary stone, or a problem from a catheter used for a procedure. These UTIs are treated with antibiotics. It's often harder to cure prostate-based infections. Treatment usually consists of long-term antibiotics, alpha-blockers, and anti-inflammatories. This condition may be life-threatening.

Other structural or functional issues. Like blockages that men might have, there can be other issues with the way the urinary system works. Things like cysts, stones and tumors can trigger more serious problems. If you've had a kidney transplant or kidney failure, that can lead to complications with a UTI. Although antibiotics are first-line therapy for a culture-proven UTI, structural abnormalities of the urinary tract may require a surgical fix to eradicate UTIs. Your doctor will still use antibiotics, but will monitor your underlying condition such as bladder or kidney stones, bladder diverticulum, or blockages of the urinary tract.