A urinary tract infection is one of the most common reasons women see a doctor. A typical bladder infection is unpleasant but usually readily treatable, and treatment can often be started without an in-person appointment. The doctor's main job is to tell an ordinary bladder infection apart from the situations that need tests or urgent care.
Typical symptoms
A bladder infection, or cystitis, usually feels like this:
- burning or pain when passing urine
- needing to go more often, and a feeling that the bladder never empties
- a strong urge to go, even though only a little urine comes out
- a heavy feeling low in the abdomen
- sometimes blood in the urine
Fever is not usually part of a simple bladder infection. If the symptoms come with fever, back pain or feeling generally unwell, the infection may have reached the kidney, and that is treated differently.
When a chat assessment and a prescription are enough
Finnish Current Care guidelines allow a typical bladder infection in an otherwise healthy, non-pregnant woman aged 18–65 to be treated on the basis of symptoms alone, without a urine test, when the symptoms are typical and there are no particular risk factors or signs of a sexually transmitted or other gynaecological infection. When those conditions are met and there is no fever, a doctor can assess the situation in a chat and send a short course of antibiotics straight to the national Prescription Centre.
It helps to tell the doctor:
- when the symptoms started and whether they are getting worse
- whether you have fever, chills or back pain
- whether you are pregnant or could be
- whether you have had urinary tract infections before, and how often
- which medicines you take and whether you have any drug allergies
- whether you have vaginal discharge or itching, since these often point to a cause other than a urinary tract infection
With mild symptoms, a doctor can also agree with a suitable patient to delay antibiotics by a couple of days, because some bladder infections clear on their own. In that case you also agree to get back in touch sooner if the symptoms get worse or you develop a fever, pain in your side or vomiting. Antibiotics shorten the symptoms but are not always necessary. The decision is made together.
When a urine test or a visit is needed
Not every urinary symptom can or should be treated remotely. A urine test, often with a culture, and if necessary an in-person visit are needed when
- you are pregnant: in pregnancy a urinary tract infection is always treated on the basis of a sample, and bacteria in the urine are treated even without symptoms
- the symptoms are in a man: a urinary tract infection in a man always needs closer investigation, because the prostate is often involved
- you have fever, chills or pain in your side: a suspected kidney infection needs tests and a longer course of treatment
- the infection keeps coming back, for example three times a year or twice in six months: then the cause is investigated and prevention is considered
- the symptoms do not ease within 2–3 days of starting antibiotics, or return straight after the course
- you have diabetes, kidney disease, a structural abnormality of the urinary tract or a catheter, or your immune system is weakened
- the symptoms are in a child
- you are over 65: in older people the symptoms are often atypical, and confusion or a general decline may be the only sign of infection
In these situations the chat doctor's job is to direct you straight to the right place, not to guess.
Self-care and prevention
- drink enough and go when you feel the need
- empty your bladder after sex
- a painkiller, used as the package leaflet directs, eases the burning
- after the menopause, local oestrogen treatment can reduce recurrences; it is worth discussing with a doctor
- cranberry products may reduce recurrences in otherwise healthy women with recurrent urinary tract infections; they do not replace treatment of an acute infection
Go to the emergency department or call 112 immediately if
- you have a high fever and chills on top of the urinary symptoms
- you get severe pain in your side or back
- you are vomiting and cannot keep fluids down
- you are confused, very weak or your blood pressure is lower than usual
- you are pregnant and have fever or pain low in the abdomen
These can be signs of a kidney infection or sepsis, which need prompt treatment.
How Treat can help
In Treat you describe your symptoms in your own words and the service asks the follow-up questions. A licensed doctor usually assesses the situation within minutes during service hours. If it is a typical bladder infection, the doctor can send the treatment straight to the national Prescription Centre, and you can collect the medicine from any pharmacy. If a urine test or a visit is needed, the doctor tells you right away.
Treat is not an emergency service. In an emergency, call 112.
This article is general health information and does not replace an individual assessment by a doctor.