One of the most common problems to affect the urinary tract is infection, most frequently affecting the urethra and bladder, and these are known as lower urinary tract infections (UTIs). They are usually caused by bacteria from the rectum getting into the urethra, and it can then spread to the bladder. UTIs are more common in women because they have a shorter urethra at around 5cm compared to 20cm in men.

Lower UTIs can spread upwards to the ureters and kidneys. This is much more serious because normal functioning may deteriorate, or renal failure can ensue. For this reason, it is very important to diagnose and treat lower UTIs as quickly as possible, and to try and prevent them happening in the first place. 

The symptoms include discomfort when urinating and in the lower abdomen, needing to go to the toilet more often and more urgently than usual, and the urine may appear cloudy, blood-stained or smell. Older patients may present with non-specific symptoms such as tiredness, appetite loss and confusion.

Self care measures include using simple analgesia and drinking plenty of fluids to try and flush through the infection and dilute the urine, making it less painful to pass. There is no evidence supporting the use of cranberry products or urine alkalinising agents, but they may encourage increased fluid intake. Antibiotics may be needed, and anyone with symptoms that haven’t improved despite self care measures, or who is feeling very unwell, plus all men, pregnant women and children, should be referred.