With recurring UTIs, it may be time to see a doctor
Published on Thursday, May 1, 2025
By: Gary Pettus, gpettus@umc.edu
If you’ve ever had a urinary tract infection, you know it can be extremely irritating and frustrating.
You may not know that it can also be life-threatening.
That’s just one reason to know when to see a doctor for a UTI – an illness caused by bacterial growth in the urinary tract: the kidneys, ureters and – most commonly – the bladder and urethra.
“Some over-the-counter medications can help with symptom relief, including Azo and Pyridium [Phenazopyridine],” said Dr. Savannah Duckworth, associate professor of medicine-internal medicine at the University of Mississippi Medical Center.
“There’s a chance that the infection could go away if you drink a ton of water early on, but, if it doesn’t, it can get complicated and trickier to treat.”
Recurring UTIs are pretty common, said Dr. Ted M. Roth, associate professor of obstetrics and gynecology and chief of the Division of Urogynecology at UMMC.
“They can be controlled through changes in lifestyle, but there are cases when you may need to see a specialist.”
Symptoms can vary among patients, but, particularly for women, “urinary urgency” is a prime one, Duckworth said.
“You need to go to the bathroom quickly, and you have a feeling of incomplete voiding. Sometimes there will be blood in the urine or a stinging sensation. There can be lower abdominal pain.
“With folks who are around age 65 and older, there could be confusion or a fever instead of the classic bladder symptoms.”
But beware: UTI symptoms often overlap with those of other conditions, such as yeast infections and prostate infections. In fact, a UTI can spread to the prostate gland, causing prostatitis. “And that requires a longer course of treatment,” Duckworth said.
The treatment for a yeast infection is much different than the treatment for a UTI, Roth said. “That’s another reason you should contact your physician about your symptoms.”
Because they have a shorter urethra, compared to a man’s, women are more likely to have a UTI, Roth said.
“A shorter urethra makes it easier for bacteria to move into the urethra and then into the bladder.”
A UTI is even more common in sexually active women, Duckworth said.
Information from the Women’s Pelvic Health and Reconstructive Surgery program at UMMC notes that, if antibiotics don’t work, there are other treatments and preventive measures: vaginal estrogen, cranberry therapy or a preventive antibiotic regimen – either post-coital (for infections apparently related to intercourse) or daily (prescribed for six to 12 months).
Because a bacterial invasion is the culprit, a patient who learns they have a UTI may believe they have done something wrong, Duckworth said.
“They say, ‘I don’t understand; I’m a clean person.’ That’s a misconception. It just happens sometimes. It’s caused by bacteria that’s not supposed to be in the genitourinary tract [urinary and reproductive systems]. It’s nothing they’ve done wrong.”
Most UTIs are caused by the bacterium E. coli, normally found in the gut; but it can move from the rectum to the urethra after a bowel movement, Roth said.
“Generally, we think of a UTI as a bladder infection,” Duckworth said. “If it’s an uncomplicated or very mild case, it can go away on its own, especially for younger folks.
“But it’s best to be safe. If someone is worried enough to call us, we ask them to bring a urinary sample. This is especially important for someone who is having frequent UTIs. We take a urine sample and culture and send it to the lab for testing – the culture results take a few days.
“You may not even need to be seen in clinic; sometimes we can do the urine sample without a formal clinic visit. But, if you have more symptoms, like worsening lower abdominal pain and chills and fever, we want you to come to the clinic right away.
“When there are symptoms, we go ahead and start you on antibiotics which can treat a UTI successfully within three to seven days. After the culture results come out, we may find that we need to change medications.”
If a severe infection is left untreated, it can cause even bigger problems that affect the kidneys, for instance. “Kidney infections are especially bad,” Duckworth said.
“It could even become a full-body, systemic infection, with a high fever and other inflammatory conditions.
“If it becomes an advanced case, it could get in the bloodstream and sepsis [often referred to as “blood poisoning”] can follow.” This can be life-threatening, and the patient may need to be hospitalized.
Most of the time, primary care physicians, including internists like Duckworth, can treat a UTI “pretty easily,” she said.
“If it’s a straightforward bladder infection, we are just thankful it’s not more serious.
“Because UTIs are so common, primary care doctors usually treat them first, before a urologist is needed.
“But we will refer a patient to a urologist if they are having recurring symptoms, frequent infections or blood in the urine sample that isn’t cleared up with antibiotics: That’s a sign that something even more serious is going on, possibly bladder cancer, for instance.
“For women who are pregnant, we refer them to an obstetrician-gynecologist.”
In any case, if you have symptoms of a bladder infection, Duckworth recommends that you call a doctor, always. “Don’t try to push through it. You might be able to, but we don’t want to miss anything,” she said.
“It’s better that you go to the clinic and get a urine sample; that way, you can know for sure what you’re dealing with.”
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For an appointment with an internal medicine specialist, call 601-984-5660; for online appointments, go here.
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