Urgent Care for Urinary Tract Infections

A urinary tract infection (UTI) is a very common infection that can be uncomfortable. If left untreated, UTIs can lead to more serious complications, like kidney infections.

Alexei Wagner, MD, MBA, an emergency medicine doctor and medical director of Mass General Brigham Virtual Urgent Care, describes treatment options for UTIs, and why it’s important to not delay getting care.

What causes a UTI?

If bacteria enters the urinary system, it can cause a UTI. The urinary system includes the urethra, kidneys, and bladder. Your kidneys filter waste and fluids from your blood in the form of urine, which then passes through the urethra. The urethra is the tube that carries urine out of the body from the bladder.

Anyone can get a UTI, though they’re more common in women and people assigned female at birth (AFAB) than others. The physical anatomy of people AFAB allows bacteria to enter the urethra more easily. More than half of people AFAB have at least one UTI at some point their lifetime. Men and people assigned male at birth (AMAB) and children also can get UTIs but it’s less common.

Other risk factors for UTIs include:

• Sexual activity

• Changes in the makeup of bacteria that live on the body. This can happen during menopause or from the use of spermicides.

• Diabetes, which can affect the immune system and the nerves responsible for fully emptying the bladder

• Pregnancy

• Problems in the urinary tract, like an enlarged prostate

• Not wiping front-to-back when using the bathroom

What are the symptoms of a UTI?

A UTI causes the lining of the urinary tract to get irritated and inflamed. Most UTIs occur in the urethra or bladder, which can cause these common signs and symptoms:

• Pain or a burning sensation while peeing

• Needing to pee frequently and urgently, even when your bladder is empty

• Cloudy or bloody urine

• Pressure or pain in the groin or lower belly

UTIs and kidney infection

Sometimes the bacteria can pass to the kidneys. This causes a more serious infection called pyelonephritis.

Kidney infection symptoms can include:

• Fever

• Lower back pain or pain on the side of the body

• Nausea or vomiting

“When the kidneys get infected, it's not just about discomfort anymore. Kidney infections can lead to more severe health issues if not treated promptly and properly. That's why pyelonephritis is considered a more serious condition than a simple UTI,” explains Dr. Wagner.

How are UTIs diagnosed?

If you think you have a UTI, your primary care provider (PCP) is a good place to start. Your doctor's office can recommend next steps and assist with any urgent issues. Many Mass General Brigham primary care practices for adults and children offer same-day, in-person, and virtual visits.

Doctors diagnose a UTI through a physical exam, including a urine sample. The sample is checked for signs of blood or bacteria in the urine, which indicates an infection. Your health care provider reviews any symptoms with you, like if you feel burning when you pee or if you need to pee more often than usual. They’ll also review your personal medical history.

UTI treatments

Most people with UTIs need medical treatment to clear up the infection, relieve symptoms quickly, and prevent the infection from getting worse.

“While some mild UTIs can improve on their own, relying on this can be risky because the infection can spread to the kidneys, turning into a more serious problem. There are also treatments available to reduce the symptoms of a UTI while antibiotics are starting to work,” says Dr. Wagner.

Antibiotics are the standard treatment for UTIs. They kill the bacteria causing the infection and prevent complications. Your provider will choose right antibiotic based on your symptoms and medical history.

For patients who get UTIs more often, your provider may take a different approach.

“These patients might need a more detailed evaluation to understand why they're getting infections frequently. In these cases, the provider may request a urine sample to get a culture or refer the patient to a specialist,” Dr. Wagner says.

Can I see a virtual doctor for a UTI?

For most UTIs, it’s often best to see a health care provider in person. With a urine culture, they can diagnose the exact strain of bacteria in your urine. This helps to determine the best treatment. If you don’t have a PCP, or no appointments are available in the near future, you can go to urgent care.

Mass General Brigham Virtual Urgent Care can be a helpful option in some cases. It’s open to all patients ages 3 and up, even if they haven’t seen a Mass General Brigham provider before. Both new and current patients can schedule a virtual urgent care visit for that day or the next day on Mass General Brigham Patient Gateway.

Virtual Urgent Care providers can diagnose a UTI by talking to you about your symptoms.

“They’ll ask questions to determine whether your symptoms and history fit with a simple or uncomplicated UTI, or if your symptoms could be from a yeast infection or sexually transmitted infection. The provider determines if you need further testing or an in-person visit. They might ask about your medical history, too. This conversation helps them figure out if it sounds like a UTI,” says Dr. Wagner.

In straightforward cases with no complex medical history, your provider may start treatment based on the symptoms you describe. For more complicated cases or if treatments aren't working as expected, they may recommend a urinalysis or urine culture.

“We offer specific, evidence-based treatments for uncomplicated UTIs, ensuring you get the high-quality care from the comfort of your home. Our platform connects you with providers who follow the latest medical guidelines to prescribe the right treatment fast. No wait, no hassle, just expert care tailored to your health history,” Dr. Wagner explains.

When to go to the emergency room for a UTI

If your symptoms worsen drastically, trust your instincts. In rare cases, bacteria from the UTI can enter the blood stream and cause sepsis. Sepsis is a life-threatening condition that requires treatment in a hospital intensive care unit (ICU). If you think you’re experiencing a medical emergency, head to the emergency room or call 911.

The following signs and symptoms indicate a more serious infection:

• Extreme pain

• High fever

• Chills

• Nausea or vomiting

• Lots of blood in the urine

• Feeling lethargic (sluggish or having low energy)

Preventing UTIs

The following tips can help prevent a UTI:

• Always wipe from front-to-back after using the bathroom.

• Pee before and after sexual activity.

• Drink plenty of fluids to stay hydrated.

• Don’t hold your urine for prolonged periods of time.

• Avoid using douches, sprays, or powder in the genital area.

You may have heard that cranberry juice or cranberry products can help prevent or treat UTIs, but medical studies have had unclear results. Speak to your care team before using these products to treat a UTI.