Is it a U.T.I. if there’s no burning sensation?
It can be. A U.T.I. can occur anywhere along the urinary tract, which includes the urethra, bladder, the kidneys and, in men, the prostate, Dr. Kim said. For an issue to be considered a U.T.I., a patient must show some symptoms and have confirmed bacteria in their urine.
A lot of the widely known symptoms, like burning and the constant sensation of needing to go to the bathroom, “come from studies that are done in young, college-aged, otherwise healthy adult women,” Dr. Gupta said. But, in fact, symptoms can vary.
In older adults, U.T.I.s might present as a fever or a feeling of fullness, she said. Some patients have lower backaches, signaling that the U.T.I. might be in the kidneys, which would make it a more acute case that can lead to sepsis and kidney damage, though those outcomes are “very, very rare,” Dr. Kim said.
Is it because I had sex?
Not necessarily. Women are often advised to urinate before and after sex to flush out any bacteria, but that practice isn’t backed by any evidence, said Dr. Benjamin Brucker, director of urogynecology at NYU Langone. “I don’t have a study to quote you that says peeing after sex or before sex reduces infections,” he said.
Anecdotally, though, that might work for some women, he added.
The most common hypothesis about a connection between sex and U.T.I.s is that the bacteria on the skin of the perineum is pushed into the urethra during penetrative sex, which can develop into a U.T.I., Dr. Gupta said. Another is that because products, like spermicides, change the microbiome of the vagina, they can create an environment in which bacteria can blossom and migrate to the urethra. But some women never develop U.T.I.s with increased sexual activity, even if they don’t urinate before or after.
