Am I At Risk for a More Serious Urinary Tract Infection (UTI)?

Written by Adrian Blackwell, MD

Most UTIs are simple, here are some factors that could put you at risk for a more serious UTI.

Are there different types of urinary tract infections (UTIs)?

Yes! For most people, UTIs are a simple problem - they are easy to treat and do not happen very often. Typically, symptoms include a few days of painful urination, frequent bathroom trips, and an overwhelming urge to pee. These symptoms are troublesome but certainly not life-threatening - they may only require a few days of antibiotics.

But some people are not so lucky - they have UTI’s over and over again, and their infections can be much harder to treat. It is easier for these UTIs to get out of control and cause kidney infections, which can get quite serious - they can even be life-threatening.

There are two basic categories of UTIs: simple and complicated. A “simple UTI” is a bladder infection in a healthy woman who does not have certain medical problems.

Some health conditions can cause UTIs to occur more often and/or make them harder to treat - these UTIs are called “complicated UTIs”. They require more antibiotics, more urine tests, and additional treatment for the other health problems too.

Do I have a complicated UTI? Which health problems put me at risk for more serious UTIs?

The list below represents common health conditions or problems that make UTIs harder to treat and/or more frequent: Male gender - men have a few extra pieces of hardware along the urinary tract that can make UTIs a more difficult issue to diagnose and treat. Sorry guys - you’ll need to be seen in person.

  • Diabetes mellitus (both insulin- and non-insulin dependent diabetics)
  • Pregnancy
  • Difficulty completely emptying the bladder (like in BPH, neurogenic bladder, etc)
  • Self-catheterization
  • Abnormal urinary tract anatomy (such as vesicoureteral reflux, duplicate ureters, etc)
  • Blockages in the urinary tract (like kidney stones, an enlarged prostate, etc)
  • A weak immune system
  • Kidney or bladder surgery
  • Urinary tract surgery (like a kidney stone stent)
  • Recent use of a Foley catheter

What medications that I’m already taking might make UTIs harder to treat?

The immune system is supposed to protect us from infections. Unfortunately there are some medical problems, called Autoimmune Diseases, where the body attacks itself. People with autoimmune disease may have to take medicines that hurt their immune system to prevent the body from attacking itself. If we use medicines to block the immune system, it might make a certain health problem better (like cancer or Crohn’s disease), but at the same time make it more difficult for your body to fight off infections naturally.

Here is a list of some common medications that can weaken someone’s immune system:

  • Steroids (like prednisone, Medrol Dosepak, etc.)
  • Chemotherapy drugs used to treat cancer
  • Anti-rejection medicines used by organ transplant patients - tacrolimus, sirolimus, mycophenolate, azathioprine, etc.
  • Infusions used to treat things like rheumatoid arthritis, psoriasis, and inflammatory bowel disease like Remicaid

There are other medicines that can weaken your immune system. Make sure to talk to your doctor about your medicines and ask if there is anything that you are taking that would fit into this category.

What other health problems can make UTIs more serious? Do I have a weak immune system?

Some people have certain medical conditions that weaken the immune system. Also, as we get older, our immune systems do not tend to be as good as they once were. Someone who has a weakened immune system is said to be “immunocompromised.” This can happen for a lot of reasons as listed below:

  • Liver Cirrhosis
  • Kidney failure and dialysis
  • Those over the age of 65
  • Uncontrolled HIV - AIDS
  • Active cancer
  • Diabetes Mellitus
  • Immunodeficiency diseases (like IgA deficiency, etc.)
  • Sickle Cell Anemia
  • Asplenia (loss of one’s spleen)
  • Bone marrow disease

If you are worried about the health of your immune system then you need to talk to your doctor. Learn how your health problems may be impacting your immune system and what that means for your overall health.

Can diabetes make my UTI worse?

Diabetes is a common health problem in our country that affects millions of people. Unfortunately, it does tend to increase the risk of kidney infections for someone who gets sick with a UTI. Diabetics who do not have good control of their blood sugar are at risk for more frequent and more serious UTIs. Diabetics who have good control of their blood sugar tend to fair as well as patients who do not have diabetes.

If you have concerns about getting your blood sugar under control you need to talk to your family doctor or your diabetes specialist (endocrinologist).

Does a previous surgery on the urinary tract make my UTI complicated?

There are a lot of reasons why people have to have surgery on their urinary tract. And to be clear, the urinary tract is like a series of pipes which includes everything from the hole where pee comes out of the body (the urethra), all the way up to the kidneys. The urethra connects to the bladder which holds the pee like a pouch. From there, the bladder connects to two tubes which are like long straws (the ureters) leading up to the kidneys on either side of someone’s upper back (see the picture below.)

urinarytract

Having a surgery or procedure done at any point of this large pipe system increases the risk for infections and makes them more difficult to treat. This includes surgeries like bladder lifts, cystoscopy, ureteral stents, kidney biopsy or surgery. Please talk to your doctor about your past surgeries so you can know if you are at risk for complicated UTIs.

Do kidney stones cause UTIs? What happens if my kidney stone gets infected?

Kidney stones are a big topic. There are multiple different types of kidney stones and different causes for each type. Regardless of the cause or type - they all increase the risk for more serious and difficult-to-treat UTIs. This is especially true when someone is passing a kidney stone. Passing a kidney stone is like pushing a big rock through a small straw. The kidney stone starts in the kidney, then moves into the long urinary straw-like tube (the ureter) on its way to the bladder. The stone is blocking that pipe and causing a lot of pain on its way to the bladder.

At this point, bacteria can get into the kidney stone and create a serious infection that can possibly become deadly. So if you have kidney stones or think you are passing one, you need to go to the ER or see your doctor in-person right away, especially if you think you might have a UTI as well. Some patients need to see a kidney stone specialist (urologist) for emergency surgery to remove the kidney stone and IV antibiotics to treat the infection.

If I’m at higher risk, what should I watch out for?

Signs of a more serious kidney infection include a fever of 100 degrees or greater, vomiting, severe back pain, and chills that make your whole body shake. If you experience any of these symptoms you need to be seen in person immediately.

The views expressed in this article intend to highlight alternative studies and induce conversation. They are the views of the author and do not necessarily represent the views of HeyDoctor, and are for informational purposes only, even if and to the extent that this article features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.

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