Diagnosis

Tests and procedures used to diagnose urinary tract infections include:

  • Analyzing a urine sample. Your doctor may ask for a urine sample for lab analysis to look for white blood cells, red blood cells or bacteria. To avoid potential contamination of the sample, you may be instructed to first wipe your genital area with an antiseptic pad and to collect the urine midstream.
  • Growing urinary tract bacteria in a lab. Lab analysis of the urine is sometimes followed by a urine culture. This test tells your doctor what bacteria are causing your infection and which medications will be most effective.
  • Creating images of your urinary tract. If you are having frequent infections that your doctor thinks may be caused by an abnormality in your urinary tract, you may have an ultrasound, a computerized tomography (CT) scan or magnetic resonance imaging (MRI). Your doctor may also use a contrast dye to highlight structures in your urinary tract.
  • Using a scope to see inside your bladder. If you have recurrent UTIs, your doctor may perform a cystoscopy, using a long, thin tube with a lens (cystoscope) to see inside your urethra and bladder. The cystoscope is inserted in your urethra and passed through to your bladder.

Treatment

Antibiotics usually are the first line treatment for urinary tract infections. Which drugs are prescribed and for how long depend on your health condition and the type of bacteria found in your urine.

Simple infection

Drugs commonly recommended for simple UTIs include:

  • Trimethoprim/sulfamethoxazole (Bactrim, Septra, others)
  • Fosfomycin (Monurol)
  • Nitrofurantoin (Macrodantin, Macrobid)
  • Cephalexin (Keflex)
  • Ceftriaxone

The group of antibiotic medicines known as fluoroquinolones — such as ciprofloxacin (Cipro), levofloxacin (Levaquin) and others — isn't commonly recommended for simple UTIs, as the risks of these medicines generally outweigh the benefits for treating uncomplicated UTIs. In some cases, such as a complicated UTI or kidney infection, your doctor might prescribe a fluoroquinolone medicine if no other treatment options exist.

Often, symptoms clear up within a few days of treatment. But you may need to continue antibiotics for a week or more. Take the entire course of antibiotics as prescribed.

For an uncomplicated UTI that occurs when you're otherwise healthy, your doctor may recommend a shorter course of treatment, such as taking an antibiotic for one to three days. But whether this short course of treatment is enough to treat your infection depends on your particular symptoms and medical history.

Your doctor may also prescribe a pain medication (analgesic) that numbs your bladder and urethra to relieve burning while urinating, but pain usually is relieved soon after starting an antibiotic.

Frequent infections

If you have frequent UTIs, your doctor may make certain treatment recommendations, such as:

  • Low-dose antibiotics, initially for six months but sometimes longer
  • Self-diagnosis and treatment, if you stay in touch with your doctor
  • A single dose of antibiotic after sexual intercourse if your infections are related to sexual activity
  • Vaginal estrogen therapy if you're postmenopausal

Severe infection

For a severe UTI, you may need treatment with intravenous antibiotics in a hospital.

Lifestyle and home remedies

Urinary tract infections can be painful, but you can take steps to ease your discomfort until antibiotics treat the infection. Follow these tips:

  • Drink plenty of water. Water helps to dilute your urine and flush out bacteria.
  • Avoid drinks that may irritate your bladder. Avoid coffee, alcohol, and soft drinks containing citrus juices or caffeine until your infection has cleared. They can irritate your bladder and tend to aggravate your frequent or urgent need to urinate.
  • Use a heating pad. Apply a warm, but not hot, heating pad to your abdomen to minimize bladder pressure or discomfort.

Alternative medicine

Many people drink cranberry juice to prevent UTIs. There's some indication that cranberry products, in either juice or tablet form, may have infection-fighting properties. Researchers continue to study the ability of cranberry juice to prevent UTIs, but results are not conclusive.

If you enjoy drinking cranberry juice and feel it helps you prevent UTIs, there's little harm in it, but watch the calories. For most people, drinking cranberry juice is safe, but some people report an upset stomach or diarrhea.

However, don't drink cranberry juice if you're taking blood-thinning medication, such as warfarin.

Preparing for your appointment

Your family doctor, nurse practitioner or other health care provider can treat most urinary tract infections. If you have frequent recurrences or a chronic kidney infection, you may be referred to a doctor who specializes in urinary disorders (urologist) or kidney disorders (nephrologist) for an evaluation.

What you can do

To prepare for your appointment:

  • Ask if there's anything you need to do in advance, such as collect a urine specimen.
  • Take note of your symptoms, even if you're not sure they're related to a UTI.
  • Make a list of all the medications, vitamins or other supplements that you take.
  • Write down questions to ask your doctor.

For a UTI, basic questions to ask your doctor include:

  • What's the most likely cause of my signs and symptoms?
  • Are there any other possible causes?
  • Do I need any tests to confirm the diagnosis?
  • What factors do you think may have contributed to my UTI?
  • What treatment approach do you recommend?
  • If the first treatment doesn't work, what will you recommend next?
  • Am I at risk of complications from this condition?
  • What is the risk that this problem will recur?
  • What steps can I take to reduce my risk of a recurrence?
  • Should I see a specialist?

Don't hesitate to ask other questions as they occur to you during your appointment.

What to expect from your doctor

Your doctor will likely ask you several questions, including:

  • When did you first notice your symptoms?
  • Have you been treated for a bladder or kidney infection in the past?
  • How severe is your discomfort?
  • How often do you urinate?
  • Are your symptoms relieved by urinating?
  • Do you have low back pain?
  • Have you had a fever?
  • Have you noticed vaginal discharge or blood in your urine?
  • Are you sexually active?
  • Do you use contraception? What kind?
  • Could you be pregnant?
  • Are you being treated for any other medical conditions?
  • Have you ever used a catheter?