Urinary Tract Infection (UTI): Symptoms, Causes & Which Doctor to See

What is a urinary tract infection and what causes it?

Most UTIs happen when bacteria from the bowel, usually E. coli, enter the urethra and travel up into the bladder. An infection of the bladder is called cystitis; if it travels to the kidneys it is pyelonephritis, which is more serious. Women get UTIs far more often than men because the urethra is shorter.

In men, UTIs are less common and more often linked to an underlying problem such as an enlarged prostate or stones, so they are always treated as complicated and need fuller assessment.

• Not drinking enough water
• Holding urine for long periods
• Sexual activity
• Menopause and vaginal dryness
• Pregnancy
• Diabetes, especially when poorly controlled
• Kidney stones or an enlarged prostate
• Urinary catheters

What are the symptoms of a UTI?

Bladder infections typically cause burning or stinging when passing urine, needing to go often and urgently, passing small amounts, lower tummy pain, and cloudy, strong-smelling or blood-stained urine. Fever is usually absent or mild.

Kidney infection adds fever, chills, pain in the side or back below the ribs, nausea and vomiting. In older people, UTIs may show up as new confusion, falls or worsening incontinence rather than classic symptoms. Similar burning can come from vaginal infections, sexually transmitted infections or kidney stones, which is why testing helps.

In pregnancy, UTIs need prompt treatment because they spread to the kidneys more easily and are linked to preterm labour. In people with a long-term urinary catheter, cloudy urine alone is common and does not always mean infection; fever, pain or feeling unwell matter more.

• Burning or pain on passing urine
• Frequent and urgent need to urinate
• Lower abdominal discomfort
• Cloudy, smelly or bloody urine
• Fever, chills and back or side pain (kidney infection)
• Confusion or falls in older adults

When is a UTI an emergency?

A UTI that spreads to the kidneys or bloodstream can become life-threatening. If any of the following apply, go to the nearest emergency department or call 112 or 108.

People with diabetes, pregnancy, a weakened immune system, a single kidney or a catheter should seek care the same day for any UTI symptoms, even mild ones.

• High fever with shivering or rigors
• Pain in the back or side with vomiting
• Confusion, drowsiness or difficulty speaking
• Cold, clammy, blotchy skin or a fast heartbeat
• Unable to pass urine or passing very little
• UTI symptoms in pregnancy with fever or back pain

Which doctor should I see for a UTI?

For a first, uncomplicated bladder infection, a physician in internal medicine can diagnose and treat it. At Lotus, the internal medicine team assesses urinary symptoms and arranges urine tests. A urologist is the right specialist when infections keep returning, when a man has a UTI, when there is visible blood in the urine, or when stones, prostate enlargement or kidney problems are suspected; the Lotus urology team assesses these.

Women in pregnancy with urinary symptoms should also inform their obstetrician. See a doctor if symptoms do not improve within 48 hours of starting treatment, or if they come back soon after finishing.

• Internal medicine: first or occasional uncomplicated UTIs
• Urology: two or more UTIs in six months or three in a year
• Urology: any UTI in a man
• Urology: blood in the urine, stones or prostate symptoms
• Obstetrics: any UTI symptoms in pregnancy

What happens at the consultation for a UTI?

The doctor asks about symptoms, how often infections happen, sexual activity, contraception, menopause, pregnancy, diabetes, kidney stones, prostate symptoms and recent antibiotics. They check temperature and examine the abdomen and back.

For recurrent infections, the doctor looks for patterns, such as infections after sex or after travel, and for underlying causes. Tell them about any antibiotics you have taken without a prescription, because this affects test results and treatment choice.

Women with vaginal discharge, itching or pain during sex may have a vaginal or sexually transmitted infection rather than, or as well as, a UTI, and may need a gynaecology review or swab tests.

• List recent antibiotics, even those bought over the counter
• Note how many infections you have had in the past year
• Mention diabetes, stones or prostate symptoms
• Collect a midstream urine sample when asked
• Ask how long to take the antibiotic and when to expect improvement

Which tests are done for a UTI?

A urine routine and microscopy and a urine culture with sensitivity testing identify the bacteria and which antibiotics will work. Ideally, the culture sample is collected before starting antibiotics. Culture is especially important in men, pregnancy, recurrent infections and when the first treatment has failed.

For recurrent or complicated infections, an ultrasound of the kidneys and bladder checks for stones, obstruction and incomplete bladder emptying. Further tests such as CT or cystoscopy are arranged for specific concerns.

• Urine routine and microscopy
• Urine culture and sensitivity
• Blood sugar or HbA1c
• Kidney function test
• Ultrasound KUB with post-void residual
• CT or cystoscopy in selected cases

How is a UTI treated?

Bladder infections are treated with a short course of an antibiotic chosen based on local resistance patterns and, where available, culture results. Take the full course exactly as prescribed. Do not use leftover antibiotics or buy them without a prescription; this is a major driver of resistance in India and can make future infections harder to treat. Paracetamol and fluids ease discomfort.

Kidney infections need longer antibiotic courses and sometimes hospital care with intravenous antibiotics. Bacteria in the urine without symptoms usually does not need antibiotics, except in pregnancy and before some urological procedures. For recurrent infections, options include treating causes, vaginal oestrogen after menopause, and preventive strategies discussed with your doctor.

Urine alkalinising sachets may ease burning for some people but do not clear infection and should not replace medical review, particularly if you have kidney disease or high blood pressure. If symptoms began after starting a diabetes medicine of the SGLT2 inhibitor type, such as dapagliflozin or empagliflozin, tell your doctor, because these medicines increase sugar in the urine and are linked to genital and urinary infections.

• Antibiotics guided by urine culture where possible
• Paracetamol for pain and fever
• Plenty of fluids
• Hospital care for severe kidney infection
• Treatment of stones, prostate problems or diabetes
• Preventive plans for recurrent UTIs

How can I prevent urinary infections?

Drink enough water through the day so your urine stays pale. Many Bengaluru office workers and commuters drink little and hold urine for hours to avoid unclean toilets or traffic delays; both increase infection risk. Carry a water bottle, plan toilet breaks and empty your bladder fully each time.

Pass urine soon after sex, wipe from front to back, avoid scented washes, douches and harsh soaps in the genital area, and wear breathable cotton underwear, especially in humid weather. Keep diabetes well controlled. Cranberry products may help prevent infections in some women but do not treat an active infection.

• Drink enough to keep urine pale
• Do not hold urine for long periods
• Urinate after sex
• Wipe from front to back
• Avoid vaginal douches and scented products
• Control blood sugar
• Never self-medicate with antibiotics

When should I follow up after a UTI?

Most bladder infections improve within two to three days of starting the right antibiotic. Contact your doctor if symptoms have not improved by then, if they worsen, or if fever or back pain develops.

If you have had two infections in six months or three in a year, arrange a review to look for causes and discuss prevention. Men, pregnant women and anyone with blood in the urine need follow-up to confirm the infection has cleared and to investigate further.

• Review if no improvement in 48 to 72 hours
• Repeat urine test when advised
• Urology review for recurrent infections
• Investigate persistent blood in the urine
• Prostate assessment for men with repeated infections