Could I have a UTI? Or is it something else?
This month is Urology Awareness Month, organised by The Urology Foundation (TUF). Every September TUF aims to raise awareness about urological illness, and we thought it would be a good idea to discuss some common urological conditions, in an effort to increase the information available for those affected.
There is no shortage of negative stigma surrounding urological illness. Research has shown that those affected can feel judged for having a health issue that is not visibly obvious, for needing to go to the toilet a lot, and for having a perceived lack of personal hygiene. 1
Stigma like this can severely affect quality of life in these patient populations, which is already challenged by the need to manage a number of debilitating symptoms.
Here is some information, which can hopefully combat some of the stigma, on a few of the main conditions causing lower urinary tract symptoms (LUTS) (e.g. pain when peeing, and needing to pee a lot), how prevalent they are, and how they can be caused (beyond personal hygiene practices!).
Urinary tract infection
Urinary tract infection is an extremely widespread urological health issue, affecting around 150 million people worldwide every year. TUF estimates that half of all women will be treated for a UTI at some point during their life. If a UTI is found in the urethra or bladder, it is classed as a ‘lower UTI’, whereas a UTI of the kidneys is called an ‘upper UTI’.
The umbrella term ‘lower UTI’ consists of urethral infection - AKA Urethritis (yuor-uh-thry-tis) - and bladder infection - AKA Cystitis (sis-ty-tis). There are a number of factors which can make some people more prone to developing UTIs, including anatomical differences, the balance of bacteria within the urinary microbiome (collection of bacterial species), and family history of UTI. The introduction and growth of bacteria in the urinary tract due to sexual activity, retaining urine for too long etc. can increase the chance of urinary tract infection.
A lower UTI could eventually spread to the kidneys if untreated, and cause a kidney infection - AKA Pyelonephritis (pai-uh-low-nuh-fry-tis). The Urology Care Foundation estimates that around 1 in 30 cases of UTI will lead to kidney infection. 2 This can be treated at home with antibiotics, but if severe may require hospital treatment.
Overactive Bladder and Urinary Incontinence
The most common symptom in overactive bladder (OAB) is a strong and frequent urge to urinate, although this condition is not caused by bacterial infection. In some cases the urge to urinate will also lead to a degree of incontinence. Approximately 33% of women and 16% of men suffer with overactive bladder. 3 Normally, when your bladder gets full, your brain sends signals to empty it, and the muscles of your bladder will work to pass urine out of your body. With OAB, the muscles are overactive, which gives the feeling of needing to pee all the time. Neurological disorders, hormonal changes, and muscle weakness are all risk factors for developing overactive bladder. 4
Urinary incontinence, on the other hand, is purely the unintentional passing of urine. It has been found that around 40% of women report continence issues, making it another highly prevalent issue. 5 Urinary incontinence is caused by pelvic floor muscle weakness or damage, which can result from e.g. pregnancy, childbirth, surgical procedures. 6
Read more in our article for World Continence Week.
Interstitial cystitis (IC)
Interstitial cystitis (in-tuh-sti-shl sis-ty-tis) - AKA painful bladder syndrome / chronic pelvic pain syndrome / frequency-urgency-dysuria syndrome - is a diagnosis of exclusion. When patients are experiencing symptoms of a urinary tract infection (needing to pee a lot and often, and pain when peeing), but tests are negative and antibiotics are ineffective, one of these diagnoses is often given. It has been suggested that up to 12% of women may show signs of having IC. 7 The cause of IC is yet to be established, and treatments aim to alleviate the severity of symptoms, as no cure is available as of yet.
You may have noticed that there is a fair bit of crossover between the main symptoms of these conditions, so if you are experiencing symptoms which are unusual for you, and are unsure whether you may have an underlying infection, it is a good idea to check for signs of infection. You can do this with the TestCard UTI test kit (available at TestCard.com or at Superdrug.com).
And whether you have a diagnosed urological condition or not, or experience one or multiple urinary symptoms, it is important to remember that you are not alone! These issues are widespread, and it is essential for patients to get the right treatment, and treatment which is in line with personal values and preferences. So don’t be afraid to talk to your doctor if you are worried.
1Elstad, E. A., Taubenberger, S. P., Botelho, E. M., & Tennstedt, S. L. (2010). Beyond incontinence: the stigma of other urinary symptoms. Journal of advanced nursing, 66(11), 2460-2470.
3Reynolds, W. S., Fowke, J., & Dmochowski, R. (2016). The burden of overactive bladder on US public health. Current bladder dysfunction reports, 11(1), 8-13.