How to prevent urinary tract infections (UTIs)

A urinary tract infection (UTI) is an infection in your urinary tract. The urinary tract is the body’s drainage system. Waste and extra fluids are removed in the form of urine.

UTIs can occur in different parts of this system, including your bladder, urethra, ureters (tubes that carry urine from the kidney to the bladder) or kidneys, but it is usually the bladder and the urethra which are affected.

Women are

to develop UTIs than men - are affected by them each year. This compares to .

Women have a shorter urethra than men, so bacteria has a shorter distance to travel before reaching the urinary tract. As a result, lifestyle factors put women more at risk of developing UTIs than men. Most methods for preventing UTIs relate to women.

If a man develops a UTI, there is a higher chance that it is a sign of an underlying health condition like diabetes or an enlarged prostate. UTIs are also

, partially as it can become more difficult to empty the bladder fully.

You can’t always prevent a UTI but all individuals who are at a higher risk can take steps to help protect themselves from infection.

Continue reading to learn more about the causes and symptoms of UTIs, who is most at risk, and the preventative methods you can try.

Symptoms of urinary tract infections

UTIs can affect different parts of your urinary tract. A bladder infection is called

and an infection of the urethra is called .

There are a number of symptoms that you might experience if you have developed a UTI, including:

• A persistent urge to pee
• Needing to pee suddenly
• Frequently passing small amounts of urine
• Pain or a burning sensation when you pee
• Urine that is cloudy
• Strong smelling urine
• Urine that is red, bright pink or blackish (a sign of blood in the urine)
• Pain in the lower tummy

UTIs can be difficult to detect in elderly people and in individuals with dementia. You might notice sudden changes in their behaviour. For example, they may become confused, agitated or withdrawn.

to confirm such symptoms are caused by UTIs in older individuals. However, it is worth making an appointment with a doctor to help determine the cause.

Children can also behave differently if they develop a UTI and may:

• Feel unwell
• Wet the bed
• Wet themselves
• Hold in their pee to avoid going to the toilet (as it might hurt)

Babies may be ill-tempered, refuse to eat and have a high temperature or fever. This means a temperature of 37.5C or above.

If you suspect that you, or anyone in your care, has developed a UTI, you should make an appointment with a doctor. Your doctor can treat the infection and check for any underlying health conditions.

A UTI can also spread to your kidneys, leading to a kidney infection. A kidney infection can cause:

• Pain in your sides or lower back
• A high temperature or fever
• Nausea or vomiting
• Diarrhoea

Who is at risk?

90% of UTIs are caused by E-coli bacteria from faeces particles getting into the urinary tract.

Women are more at risk of UTIs because they have a shorter urethra than men so bacteria can reach their kidneys and bladder more easily.

For women, their urethra is closer to their anus than men, so bacteria from faeces is more likely to reach the urethral opening.

Additionally, there are other factors which can increase an individual’s risk of developing UTIs, including:

• Pregnancy
• Conditions that make it harder to empty the bladder (e.g. kidney stones or an enlarged prostate)
• Dehydration (leading to a lack of urination)
• A weakened immune system (possibly caused by diabetes, HIV or certain medications)
• Old age (peeing can become more difficult)
• Urinary incontinence
• Not being circumcised
• Previous UTIs
• Being sexually active (foreplay and sex can spread bacteria from the genitals and anus to the urethra)
• Having a urinary catheter or other medical instrument inserted into the urethra
• Using a diaphragm (a silicon device inserted into the vagina to block semen) as a method of birth control

The menopause can also increase the risk of UTIs. There is a link between higher levels of oestrogen and the good bacteria, lactobacillus, which can protect against bad bacteria.

Oestrogen levels drop as women age, possibly leaving them more vulnerable to infection.

Preventing urinary tract infections with lifestyle changes

If you are at higher risk of developing a UTI, you should take extra precautions to limit the amount of harmful bacteria in your urinary tract.

Peeing is one of the best ways to clear bacteria from your urethra. Try drinking plenty of fluids so you go to the toilet more frequently.

In addition, you can lower your risk of developing a UTI by:

• Urinating before and after sex
• Taking showers instead of baths
• Wiping from front to back when you go to the toilet
• Cleaning yourself immediately after anal sex
• Trying to fully empty your bladder when you pee

To reduce your chances of developing a UTI, avoid the following:

• Harsh chemicals, perfumed bubble baths and soaps
• Talcum powder
• Holding in your pee for long periods of time
• Tight jeans or trousers
• Underwear made from synthetic materials like nylon
• Irritating vaginal products if you are a woman (e.g. perfumes and deodorants)

Women can try swapping diaphragms or spermicidal products for different forms of birth control.

Spermicide is a substance which coats some condoms to kill sperm, but it can also kill the good bacteria around a woman’s vagina.

Preventing urinary tract infections with home remedies

There is not enough evidence to prove these home remedies are effective, but you can try them and see if they make a difference for you.

Probiotics

There is some

that probiotics can help to replenish the body’s store of the good bacteria lactobacillus. It is possible this can help combat the spread of bad bacteria.

Vitamin C

Consuming vitamin C may make your urine more acidic. This might help kill harmful bacteria in your urinary tract.

The effectiveness of this method and the extent to which vitamin C actually acidifies urine is

. Additionally, good bacteria can be killed by acidic urine, which may lead to more bad bacteria.

Some may find drinking vitamin C helpful simply because they are drinking more liquid. You can see if consuming more vitamin C helps you prevents UTIs, although it might be just as beneficial to drink more water.

Cranberry juice and supplements

Cranberry juice contains an active ingredient known as A-type proanthocyanidins (PACs) which helps prevent harmful bacteria, and in particular E-coli, from sticking to the walls of the urinary tract.

However,

suggests that this method is not very effective. While the exact reason is not known, there may not be enough of this ingredient in either the juice or supplements to have any beneficial effect.

Like with vitamin C, it is possible that drinking cranberry juice prevents UTIs by keeping individuals more hydrated and encouraging them to go to the toilet more.

Preventing urinary tract infections with medication

UTIs are typically treated with antibiotics. If you are suffering from recurrent UTIs, it may be worth asking your doctor for a repeat prescription to prevent the infection from coming back.

If you are taking antibiotics to treat an existing infection, it can take a few days for your symptoms to clear. To ease any pain or discomfort during this time, you can:

• Place a hot water bottle on you tummy, back or between your thighs
• Take time to rest and recover
• Drink lots of fluids to help flush out bacteria

A doctor may also advise taking painkillers such as paracetamol. Speak to your pharmacist or doctor for further guidance on whether to use these medications and how to get and use them.

There is also

that applying creams or gels containing the hormone oestrogen directly to the vaginal area can prevent UTIs.

Oestrogen may help promote the body’s natural production of the good bacteria lactobacillus, which can protect against harmful bacteria.

However, this process is poorly understood and conversely, oestrogen may also make it easier for bacteria to invade the body’s cells.

Conclusion

You cannot always prevent a UTI from developing, particularly if it is caused by another health condition, but you can maintain lifestyle habits which reduce your risk.

There are several at home remedies that you can try, such as drinking cranberry juice or taking supplements, but there is not enough evidence to confirm these are effective.

In some cases - as with topical oestrogen - it is possible the treatment may aggravate, rather than improve, the condition.

Trustworthy ways to lower your risk include drinking plenty of water and limiting the spread of bacteria from your anus to your urinary tract.

If none of these methods help you prevent infections from returning, you should make an appointment with your doctor. A long course of antibiotics or a repeat prescription may benefit you.