What is a UTI and how do you get it?

Was ist eine Harnwegsinfektion?

Ein Harnwegsinfektion, known as a UTI, means that the part of your body that makes and dispenses urine (wee) - your urinary tract - has become infected by germs or bacteria.

Your urinary tract includes your:

• Kidneys - which filter out waste products from your blood to create urine.

• Ureters - the tubes between your kidneys and bladder.

• Bladder - holds your urine and signals when you need to urinate.

• Urethra - the tube through which urine leaves the body.

Most UTIs occur in your bladder, known as a lower urinary tract infection. They are often caused by a type of bacteria called E. coli but other bacteria can cause UTIs too. They can be painful and debilitating, but they are treatable and aren't serious or life-threatening - unless the infection spreads to your kidneys.

Common types of UTIs

The type of UTI you have depends on where you are infected. For example:

• Zystitis - a bladder infection.

• Vaginitis - a vaginal infection

• Pyelonephritis - a kidney infection.

• Urethritis - a urethra infection.

The germs and bacteria that can cause a UTI can live in your body without causing you harm. However, they can sometimes travel through the tubes in your urinary tract. For example, E. coli - the most common cause of UTIs - normally live in your bowel, but after you poo these bacteria are sometimes pushed to your anus where they can then travel up your urethra to your bladder - especially if, as a woman, you forget to wipe front to back.

Dr Paul Ettlinger, GP at Die Allgemeinarztpraxis London, explains that UTIs are more common in women because the female urethra, the tube carrying urine from the bladder out of the body, is shorter and closer to the anus and vagina. This makes it easier for bacteria to enter the urinary tract. The doctor goes on to describe other possible causes of UTIs:

"Congenital abnormalities - structural abnormalities present from birth - of your urinary tract can also cause UTIs due to a build-up of urine," he says.

"Likewise, blockages in the urinary tract - such as Nierensteine - may block the flow of urine between your kidneys and bladder and lead to infection. "

The doctor adds that Diabetes also makes you more vulnerable to UTIs in several ways: by weakening your immune system, through nerve damage that makes it hard to fully empty your bladder, and by having higher levels of sugar in your urine that encourages bacteria.

The above causes aren't gender-specific, yet research suggests that 50-60% of adult women¹ will get a UTI at some point - and this is compared to just 5% of adult men². How do you get a UTI as a women and why are they so much more common?

According to Dr Ettlinger, women face several additional risk factors throughout their lifetime:

1. Geschlecht - the anatomy of women means sexual intercourse can increase the risk of getting a UTI as sexual contact can allow bacteria near the vagina to get into the urethra.

2. Birth control - using a diaphragm or spermicide for birth control can lead to UTIs by increasing bacteria growth.

3. Schwangerschaft - the uterus grows during pregnancy and the extra weight may cause urine to drain from the bladder less efficiently, causing a UTI.

4. Physical changes during midlife - including thinning of vaginal tissue, pelvic organ prolapse, incontinence, and trouble completely emptying the bladder.

5. Hormonal changes after the menopause - the drop in oestrogen levels causes changes in the urethra and the vagina to become drier and more delicate, making it more prone to infection.

As a result of the physical changes brought about by age and Wechseljahre, UTIs are twice as common in women aged over 65 years than in the general female population¹.

Men can also get UTIs but have fewer biological traits that increase the risk. An enlarged prostate is the main threat. This is where the prostate gland, which helps make semen, gets larger and squashes the urethra. Alongside other problems while peeing, this can make it harder to empty the bladder, increasing bacteria build-up.

An enlarged prostate isn't necessarily considered a health issue - it's normal for a man's prostate to continue growing with age. This makes UTIs more common in older men, and symptoms of a UTI should still be treated in order to clear up the infection. However, any changes in urination in men warrants a review by a doctor to make sure there are no sinister causes such as Prostatakrebs that are blocking the urethra.

"Visit your local GP if you notice any of these signs," advises Dr Ettlinger, "UTIs are treated with antibiotics that can kill the bacteria causing the infection."

There are also other ways to help you get rid of a UTI. In the article, 9 ways to get rid of a UTI, we ask the experts the best methods - both medical and non-medical - to help clear up your infection and rid you of the discomfort, so you can get back to feeling like yourself again.

1. Medina and Castello-Pino: An introduction to the epidemiology and burden of urinary tract infections.

2. Better Health: Urinary tract infections (UTI).