Urinary Tract Infection in Women: When should one seek medical advice?

Urinary tract infection (UTI) is a common infection for which women visit their doctor. It is usually caused by bacteria that enter the urethra and then the bladder. UTI can involve any part of the urinary tract (the upper urinary tract i.e. the kidney and ureter or the lower urinary tract i.e. the bladder and urethra). Treatment of UTI depends on many factors including the severity of infection, your health condition and the causative bacterium. Most women with UTI respond well to treatment, but if it is not treated appropriately, complications may occur.

Consult your doctor if:

• you have symptoms of lower UTI, such as cloudy urine, increased frequency of urination (i.e. you may have to urinate more frequently either during the day, at night or both), pain or discomfort on urination, urgency to urinate (i.e. holding urine becomes more difficult when you have an urge to urinate), foul smell or unpleasant smell in urine
• you have symptoms of upper UTI, such as fever with chills, nausea and vomiting, diarrhoea, back pain or pain in your side or groin (can vary in severity from moderate to severe, which may worsen on passing urine)
• symptoms of UTI do not improve in a few days of starting oral antibiotic treatment
• you develop complications, such as severe vomiting, severe pain on passing urine, dehydration, inability to pass urine
• you have high fever for more than a few days after starting treatment
• you have recurrent UTI
• you have risk factors that increase the risk of complications or severe infection, such as diabetes, kidney problems, cancer or a weak immune system
• you are older than 65 years
• you have blockage in the kidneys, such as because of kidney stone
• you are pregnant

Who to consult

Some health professionals, who can be consulted for urinary tract infection include:

• family physicians.
• nurse practitioners.
• physician assistants.
• internists
• gynaecologist (a doctor who specialises in diagnosis and treatment of disease of the female genital tract)
• Nephrologist (a doctor who specialises in diagnosis and treatment of diseases of kidney)