Uncomplicated Urinary Tract Infection

A urinary tract infection (UTI) is one of the most common bacterial infections (caused by the bacteria Escherichia coli – E. coli) that can occur in women between the ages of 16 and 64. Approximately half of women have at least one UTI in their lifetime, and 20-30% have two or more. In fact 25% of women who have a UTI can have a recurrent episode within 3-6 months and 40% have a recurrence within 12 months. It’s worth remembering that a UTI is not a gynaecological disease.

What is the urinary tract?

The urinary tract is the body’s drainage system for removing urine. It consists of 4 components:

• Kidneys – these are small, bean-shaped organs on the back of your body, above your hips. The kidneys filter water and waste products from your blood, which becomes urine.
• Ureters – these are thin tubes that carry urine from your kidneys to your bladder.
• Bladder – this is a balloon-like organ that stores urine before it leaves your body.
• Urethra – this is a tube that carries pee from your bladder to the outside of your body.

What are the types of Urinary Tract Infections (UTIs)?

UTIs are clinically classified as being either:

• Uncomplicated – a bacterial Infection of the bladder that is not associated with structural or functional abnormality of the urinary tract and where the individual has no underlying chronic conditions such as diabetes, is not immunocompromised, has not had recent urologic surgery, or is not pregnant
• Complicated – a bacterial Infection that is linked with a condition, such as a structural or functional abnormality of the urinary tract, or the presence of an underlying disease

What are the different types of uncomplicated Urinary Tract Infections (UTIs)?

Uncomplicated UTIs normally affect individuals who are otherwise healthy and have no structural or functional abnormality of the urinary tract. Uncomplicated UTIs are further classified into either:

• Uncomplicated lower UTIs (acute cystitis – affecting bladder)
• Uncomplicated upper UTIs (acute pyelonephritis – affecting kidneys)

Uncomplicated UTIs usually resolve within a few days, with or without treatment. Treatment with antibiotics can however reduce the length of the episode by a day or two and can also prevent complications.

What are the causes of uncomplicated UTIs?

Uncomplicated UTIs are caused by bacteria such as E. coli entering your urinary tract. Because women have a shorter urethra than men, the bacteria are more likely to travel to the bladder or kidneys and cause an infection.

Factors that can increase the risk of getting Uncomplicated UTI?

The following factors can increase your risk of getting an uncomplicated UTI:

• Frequent sexual activity
• New sexual partners
• Some types of birth control
• Menopause

How to prevent Uncomplicated UTIs?

UTIs can’t always be prevented, however, it is possible to reduce your risk of getting one. The following are things you can do to prevent a UTI:

• Keep the genital area clean and dry
• Wipe from front to back when you go to the toilet
• Drink plenty of fluids, particularly water – so that you regularly urinate during the day and do not feel thirsty
• Wash the skin around the vagina with water before and after sex
• Urinate as soon as possible after sex
• Explore different birth control options – Some types of birth control might promote an overgrowth of harmful bacteria including:
  • Diaphragms
  • Non-lubricated condoms
  • Spermicides
  • Spermicide condoms

What are the symptoms of Uncomplicated UTI?

Symptoms of an Uncomplicated UTI may include:

• Pain or a burning sensation when passing urine (dysuria)
• Needing to pass urine more often than usual
• Needing to pass urine more often than usual during the night (nocturia)
• Needing to pass urine suddenly or more urgently than usual
• Urine that looks cloudy
• Blood in your pee
• Lower tummy pain or pain in your back, just under the ribs
• A high temperature, or feeling hot and shivery
• A very low temperature below 36C

Is an Uncomplicated UTI contagious?

Uncomplicated UTIs are not contagious and cannot be sexually transmitted.

When to get advice from a GP

You should contact your GP if you suspect you have a UTI and you:

• Have symptoms of a urinary tract infection (UTI) for the first time
• Have a child has symptoms of a UTI
• Are a man with symptoms of a UTI
• Are pregnant and have symptoms of a UTI
• Are caring for an older, frail person who may have symptoms of a UTI
• Have symptoms of a UTI after surgery
• Have symptoms that get worse or do not improve within 2 days
• Have symptoms that come back after treatment
• Are immunosuppressed because of an underlying condition or because of treatment e.g chemotherapy
• Have associated vaginal discharge

You should seek an emergency GP appointment or Call NHS 111 immediately if you experience the following symptoms:

• Have a very high temperature, or feel hot and shivery
• Have a very low temperature below 36C
• Are confused or drowsy
• Have pain in the lower tummy or in the back, just under the ribs
• Can see blood when you pass urine

Check if you qualify for FREE treatment with NHS Pharmacy First, without seeing your GP

You can check your eligibility to use the NHS Pharmacy First service if you suspect you have an uncomplicated UTI and you:

• Are a biological female aged between 18 years and 64 years

And you have ONE or more of the following symptoms:

• Dysuria (burning pain when passing urine)
• New nocturia (needing to pass urine in the night)
• Urine cloudy to the naked eye (visual inspection by pharmacist if practicable)

The NHS Pharmacy First service is available to all NowPatient users who are registered with the NHS in England. If you are exempt from paying for your prescriptions, the service and the treatments are provided free of charge. If you are not exempt from paying prescription charges, treatments are provided at the prevailing NHS prescription charge rate. There is no charge for consultations.

What NHS Pharmacy First treatments are available for Uncomplicated UTIs?

Although many cases of Uncomplicated UTIs tend to self-resolve, you may find that the symptoms may warrant treatment. You have a number of self-care and referral options:

• Purchase an over-the-counter painkiller from a store
• Refer to the NowPatient NHS Pharmacy FIrst service where you will be assessed and possibly given a prescription for a short course of antibiotics
• If there are warning signs and you are not eligible to use the NHS Pharmacy First service, then self-refer to a GP

It’s important to take all the medicine you’re prescribed, even if you start to feel better.

Sources

• Urinary tract infections: epidemiology, mechanisms of infection and treatment options
• Symptomatic treatment of uncomplicated lower urinary tract infections in the ambulatory setting: randomised, double blind trial
• NHS – Urinary Track Infections
• Cleveland Clinic – Urinary Track Infections
• NHS – Cystitis