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Urine Infection Care · Imphal

Urine infections,
treated properly.

Burning, frequency and lower belly pain are common — especially in women. Most infections settle quickly with the right antibiotic. Infections that keep coming back need the cause to be found.

● Urine culture before antibiotics ● Same-visit ultrasound ● Recurrent UTI evaluation ● Women, men & children
Dr. Nameirakpam Shantajit
Dr. Nameirakpam ShantajitMBBS (SPMC Bikaner) · MS Surgery & M.Ch Urology (RIMS Imphal) · MMC Reg. No. MNP 150

▶ How a urine infection happens — a 40-second animation with voice (subtitles are shown in the video). Download the video to share on WhatsApp.
Narration: synthetic voice (Piper text-to-speech, LibriTTS dataset, CC BY 4.0).

CultureUrine test picks the right antibiotic
Few daysMost simple bladder infections settle
2 in 6 monthsOr 3 in a year = recurrent UTI
Find the causeStones, emptying problems, prostate
Symptoms

Signs of a urine infection

Bladder infections (cystitis) are the most common. When the infection reaches the kidney (pyelonephritis), it becomes more serious.

🔥

Burning when passing urine

Pain or stinging, often the first sign.

⏱️

Frequency & urgency

Needing to go often, sometimes passing only small amounts.

💧

Cloudy or smelly urine

Sometimes with blood or a pink tinge.

😣

Lower belly discomfort

Pressure or pain above the pubic bone.

🌡️

Fever, chills, back pain

Suggests a kidney infection — needs prompt treatment.

🤢

Vomiting or confusion

Especially in elderly people — go to hospital.

Who Gets UTIs

Why some people get them more

👩

Women

A shorter urethra lets bacteria reach the bladder more easily. Risk rises with sexual activity, pregnancy and after menopause.

👨

Men

UTIs are less common in men, so an infection usually points to a cause — an enlarged prostate, stones or incomplete emptying — and should always be evaluated.

🧒

Children

A UTI in a child, especially with fever, needs evaluation to check for problems in how the urinary tract drains. Constipation is a common contributor.

🩸

Diabetes

High blood sugar makes infections more frequent and more severe. Good sugar control helps.

🪨

Stones or blockage

Stones, a stent or a narrowed passage can hold bacteria and keep infections returning.

🚰

Catheters & poor emptying

Urine left behind in the bladder lets bacteria multiply.

Tests

Getting the diagnosis right

Ideally, a urine sample is sent before antibiotics are started — so the right medicine can be chosen.

Urine routine & culture

Confirms infection and shows which antibiotics will work. Report usually in 2–3 days.

Ultrasound

Kidneys and bladder in the same visit — checks for stones, blockage and urine left after voiding.

Blood tests

Sugar and kidney function, and blood counts when there is fever.

Further tests if recurrent

Uroflowmetry, CT scan or cystoscopy in selected patients, to find a cause.

How to give a clean urine sample

A "midstream" sample. A contaminated sample is the commonest reason for a misleading culture report — and a repeat test.

1

Wash your hands

With soap and water. Open the sterile container only when ready — don't touch the inside or the lid.

2

Clean the area

Wash the genital area with plain water (no antiseptic). Women: separate the labia and wipe front to back. Men: pull back the foreskin.

3

Pass the first part into the toilet

This washes away germs at the opening that would spoil the result.

4

Catch the middle part

Collect the middle of the stream (about half the container), finish in the toilet, and close the lid tightly.

⏱️ Give it to the lab within 1–2 hours❄️ If delayed, keep it in the fridge — not the freezer💊 Best collected before starting antibiotics🌅 An early-morning sample is ideal
Treatment

The right antibiotic, for the right time

Simple bladder infection

Short course

A few days of an antibiotic suited to you, plenty of fluids and pain relief. Symptoms usually improve within 1–2 days.

Kidney infection

Longer course

A longer course, sometimes starting with injections in hospital if there is high fever or vomiting.

Recurrent or complicated

Treat the cause

Culture-guided treatment plus correcting the cause — stones, prostate, emptying problems — and a prevention plan.

Please avoid self-medicationTaking leftover or over-the-counter antibiotics without a culture is a major cause of resistant infections that are hard to treat. Always complete the course you are prescribed.
While you recover
  • Drink 2.5–3 litres of fluid a day unless told otherwise
  • Don't hold urine for long
  • Come back if fever starts or symptoms don't improve in 2–3 days
Special situations

When a UTI needs extra care

🤰

UTI in pregnancy

  • Urine culture is checked in early pregnancy
  • Germs are treated even without symptoms — they can lead to kidney infection
  • Only pregnancy-safe antibiotics are used — never self-medicate
  • Fever or back pain in pregnancy: go to hospital
🔬

Germs in urine, but no symptoms

  • Called asymptomatic bacteriuria — common in elderly people, diabetics and those with a catheter
  • Usually it is not treated: antibiotics don't help and breed resistance
  • Treated only in pregnancy and before urological procedures (like TURP or URS)
👨

UTI in men

  • Never a "simple" UTI — the prostate is often involved (prostatitis)
  • Signs: fever, pain between the legs, difficulty passing urine
  • Usually a longer course of antibiotics. Prostatitis & abscess guide →
  • Flow test, residual urine and prostate check afterwards. PSA rises during infection — test later. About PSA →
💊

Diabetes medicines & infection

  • "Gliflozin" medicines (e.g. dapagliflozin, empagliflozin) put sugar into the urine
  • This can cause genital itching or fungal infection, and sometimes UTI
  • Keep the area clean and dry; drink enough water
  • Don't stop the medicine yourself — ask your doctor
  • Pain, swelling or redness of the genital area with fever = emergency
🩺

Living with a catheter

  • Wash hands before touching it; clean around it daily with soap and water
  • Keep the bag below bladder level, off the floor; empty it when ⅔ full
  • Don't disconnect the tube from the bag; drink plenty unless told otherwise
  • See a doctor for fever, no drainage, bleeding or pain. Cloudy urine without fever is common.
🧒

Children

  • In babies, fever without an obvious cause can be a UTI — a urine test is essential
  • Older children: burning, wetting again, tummy pain
  • Repeated UTIs need a check for reflux or blockage
  • Children's urology guide →
🪨🔥

Stone + fever = an emergency

When a stone blocks the kidney and infection sets in, pus collects behind the blockage. Antibiotics alone cannot clear it — the kidney needs urgent drainage with a DJ stent or a PCN tube. The stone is treated later, once the infection has settled.

Kidney stone guide →
Diabetes & kidney infection

Emphysematous pyelonephritis: a gas-forming kidney infection

A rare but life-threatening kidney infection in which germs produce gas inside the kidney. It happens mostly in people with diabetes, especially when sugar is poorly controlled, and sometimes when the kidney is blocked by a stone. It needs emergency hospital treatment.

Gas PelvisOn a CT scan, gas shows up as black pockets inside the kidney.

👥 Who is at risk

  • Diabetes — about 9 in 10 patients
  • High or uncontrolled blood sugar
  • A blocked kidney (stone, narrowing)
  • More common in women

🚨 Warning signs

  • High fever with chills
  • Side or back pain, vomiting
  • Very high sugar, feeling very unwell
  • Drowsiness, confusion, low BP

🩻 How it is diagnosed

  • CT scan — confirms gas and its extent
  • Blood tests: sugar, kidney function, platelets
  • Urine and blood culture

🏥 How it is treated

  • Admission, IV antibiotics & fluids
  • Strict sugar control
  • Drainage — DJ stent or a tube through the back (PCN)
  • Rarely, removal of the kidney if severe
How severe? — the CT classes

Doctors grade it from the CT scan (Huang–Tseng classes). The higher the class, the more serious it is — this helps decide whether drainage is enough or surgery is needed.

Class 1

Gas in the urine-collecting part (pelvis) only

Class 2

Gas inside the kidney tissue

Class 3

Gas or pus spreading outside the kidney

Class 4

Both kidneys affected — or a single kidney

⚠️

Diabetic with fever and side pain? Don't wait.

Go to a hospital emergency the same day. Early CT, antibiotics and drainage save kidneys — and lives. Keeping your sugar under control is the best prevention.

Recurrent UTI

When infections keep coming back

Two or more infections in 6 months — or three or more in a year — is called recurrent UTI. It needs an evaluation, not just repeated antibiotics.

💧

Everyday habits

Drink enough water, pass urine regularly and fully, pass urine soon after intercourse, wipe front to back, and avoid constipation.

🔍

Look for a cause

Ultrasound for stones and residual urine, sugar testing, and in some patients flow tests, CT or cystoscopy.

🌸

After menopause

Low-dose vaginal oestrogen, prescribed after assessment, can reduce infections in some women.

💊

Preventive treatment

For selected patients, a low-dose preventive antibiotic or other options may be advised for a limited period — only after culture and review.

🚑

Go to the nearest hospital emergency if you have

  • High fever with chills, or shivering
  • Back or side pain with vomiting
  • Confusion or drowsiness in an elderly person
  • Fever with a kidney stone or a DJ stent in place
  • Fever during pregnancy
  • Fever with side pain in a person with diabetes
  • Unable to pass urine
WhatsApp numbers and the chatbot are not emergency services.
Myths & facts

What people often believe

MYTHBurning urine is due to "body heat" — cooling drinks will fix it.
FACTBurning is usually an infection, sometimes a stone. Get a urine test.
MYTHUTIs come from public toilet seats.
FACTRarely. Most UTIs come from a person's own bowel germs.
MYTHCranberry juice cures a UTI.
FACTIt does not treat infection. It may slightly reduce repeat infections in some women.
MYTHDrinking lots of water alone will cure it.
FACTWater helps, but a true infection usually needs the right antibiotic.
MYTHI can stop the antibiotic once I feel better.
FACTComplete the course — stopping early lets the infection return, stronger.
MYTHOnly women get UTIs.
FACTMen and children get them too — and in men they need a check-up.
Questions

Frequently asked questions

Can I take antibiotics I have at home?

Please don't. Leftover or over-the-counter antibiotics may be the wrong drug or the wrong dose, and they can make the infection resistant. A urine culture helps choose the right antibiotic.

Why is a urine culture needed?

It confirms the infection and shows which antibiotics the bacteria are sensitive to. This matters most for repeated or severe infections, where common antibiotics often don't work.

Why do I keep getting UTIs?

Common reasons include not emptying the bladder fully, stones, diabetes, changes after menopause, constipation and sexual activity. An evaluation looks for a cause that can be corrected.

Is a UTI sexually transmitted?

A UTI is not a sexually transmitted infection, but sexual activity can push bacteria towards the bladder. Passing urine soon after intercourse helps.

Does cranberry juice prevent UTIs?

Evidence is mixed. Cranberry products may help a little for some women, but they do not treat an infection and are not a substitute for proper evaluation.

Do men with a UTI need tests?

Yes. UTIs are less common in men, so an infection usually has a cause — such as an enlarged prostate, a stone or incomplete emptying — that should be checked.

Can a UTI damage the kidneys?

A simple bladder infection rarely does. A kidney infection, especially with a blockage such as a stone, can be serious and needs prompt treatment.

What is emphysematous pyelonephritis?

A rare, severe kidney infection in which germs produce gas inside the kidney. It occurs mostly in people with diabetes, especially with poor sugar control, or when the kidney is blocked. Symptoms are high fever, side pain, vomiting and feeling very unwell. It is diagnosed with a CT scan and treated urgently in hospital with IV antibiotics, sugar control and drainage of the kidney (DJ stent or PCN tube); occasionally the kidney has to be removed.

How do I give a proper urine sample?

Wash your hands, clean the genital area with plain water, pass the first part of the urine into the toilet, and collect the middle part in a sterile container without touching the inside. Give it to the lab within 1–2 hours, or keep it in the fridge if there is a delay.

Is a UTI in pregnancy dangerous?

It needs prompt treatment because it can spread to the kidneys more easily in pregnancy. Urine is checked in early pregnancy and germs are treated even without symptoms, using only pregnancy-safe antibiotics.

My urine culture shows germs but I have no symptoms. Do I need antibiotics?

Usually not. This is common in elderly people, diabetics and people with a catheter, and treating it does not help. It is treated mainly in pregnancy and before urological procedures.

Does cranberry juice cure a UTI?

No. It does not treat an infection. It may slightly reduce repeat infections in some women, but it is not a substitute for proper treatment.

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Medically reviewed by Dr. Nameirakpam Shantajit, M.Ch Urology (MMC Reg. No. MNP 150) · Last reviewed: 10 October 2026

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