Why does a Urinary Tract Infection cause a strong, persistent urge to urinate?

There are plenty of articles on the fact the a urinary tract infection (UTI) causes frequent and urgent urination. For example; on this National Institutes of Health webpage.

My question is:

  • Why does a urinary tract infection cause an increased desire and hence, a greater urgency to urinate?

Nerve endings exist in a more or less homeostatic interstitial fluid medium which when disturbed in certain ways result in depolarization. This is a very simple explanation, but basically correct. Depending on the nerves being discussed, a change in the medium can be the presence/absence of neurotransmitters (serotonin, GABA, etc.), chemicals released from damaged tissue, pH differences, etc. etc.

Very simply put, anything causing irritation of the bladder or urethral mucosa will cause some of the nerve endings to depolarize; these are some of the same nerves that depolarize when the bladder is full, and therefore the sensation is of urgency (the feeling that one needs to urinate). The substances can be substances excreted by bacteria, released by neutrophils, or some other.

Simply administering a topical anesthetic - something that decreases the depolarization of nerve endings by reversibly binding to/inactivating sodium channels - (lidocaine, for example) will instantly alleviate this sensation. In the case of UTIs, a commonly given medication is the bladder anesthetic phenazopyridine hydrochloride.

The more complex answer is that no one exactly knows. The complexity is more important in the treatment of non-infectious causes of urinary urgency and in the investigation of why catheter-related UTI are often asymptomatic.

Edited to add: If you're looking for a more teleological reason (such as, it hurts so that you'll get flush out the bacteria faster, that's not actually what happens. When it hurts to urinate, very many women intuitively stop drinking fluids in an attempt to avoid the pain of urination, allowing the infection to get much worse. The counterintuitive measure is to drink more, not less, to flush out bacteria.

What is urinary urgency and frequency?

Urinary urgency and frequency is a condition that increases how strongly or how often you need to urinate. The condition may also be called urgency-frequency syndrome. Urinary urgency means you feel such a strong need to urinate that you have trouble waiting. You may also feel discomfort in your bladder. Urinary frequency means you need to urinate many times during the day. This may also be called increased daytime frequency. You may be woken from sleep by the need to urinate. Urgency and frequency often happen together, but you may only have one.

Constant Urge To Pee: Does Needing To Urinate More Often Than Usual Mean You Have A UTI?

No one enjoys symptoms and conditions related to urinary issues, and some may be especially irritating, such as having a constant or urgent need to urinate. Sometimes, this can also be a big hassle, especially for those who travel, have long commutes to and from work, are on a sales floor during the day and can’t escape to the restroom quickly, and anyone with a very active social life.

What is a UTI?

Just as bacteria can infect other areas of the body, they sometimes cause infection in the urinary tract, including the bladder and kidneys. A UTI is often easily remedied with a short visit to the doctor and a prescription for antibiotics, though sometimes, the particular bacteria only respond to certain medications. In those cases, it may take more than one round of antibiotics to rid the system of the infection.

UTIs are common, especially in women, though men are susceptible as well. They can occur more frequently if a person is dehydrated, has recently had a catheter, or has kidney disease. One of the most common symptoms of a UTI, aside from burning and pain while urinating, is the frequent, urgent need to pee. Normally, an urge to urinate can be controlled, but the inflammation and irritation in the urinary tract can make that more difficult. In addition, it can sometimes lead to the “phantom” need to urinate, with nothing being expelled.

Other causes of frequent urination

Of course, this isn’t the only symptom of a UTI, and upon a visit to the doctor, a patient might find that their experience points to some other underlying cause. In this case, it’s important to follow up and let the physician perform a more extensive medical history and perhaps take more tests. Some of these other conditions could be more serious.

  • Diuretics. While taking a diuretic to flush fluid out of the body based on swelling is the most common use, some people don’t realize other medications they take have similar properties. For example, blood pressure medication acts as a diuretic. Also, caffeine is a diuretic, so consuming large amounts of coffee, sodas, or energy drinks could lead to frequent urination.
  • Overactive bladder. Some mistake this as a symptom, when it is actually a cause. An overactive bladder contracts involuntarily, and this could cause a patient to feel as though they need to urinate, even immediately after they have emptied the bladder. It is also a reason that many people awaken several times during the night to use the restroom.
  • Bladder cancer. This is rare in younger patients, but it is typified by the frequent and urgent need to pee, accompanied by blood in the urine. However, unlike a UTI, this is rarely painful. Experiencing these symptoms without pain should trigger an immediate visit to a physician.
  • Diabetes. In patients suffering from both Type I and Type II diabetes, frequent need to urinate occurs especially when blood sugars are not controlled. This is one of the ways the body attempts to rid itself of excess glucose.
  • Neurological conditions. Some conditions damage the nerves that control bladder function, which can lead to the frequent need to urinate and incontinence. Such conditions include Parkinson’s disease, stroke, and multiple sclerosis.
  • Interstitial cystitis. With this sort of condition, which includes inflammation of the bladder, excruciating pain, and the need to urinate as many as sixty times per day, a patient will need to seek treatment for symptoms, as there is no cure.
  • Ovarian cancer. There are few symptoms of ovarian cancer early on, which can lead to it spreading before it has been caught. In order to assure this doesn’t happen, a patient who either has a frequent urge to urinate and can’t, or someone who is urinating more often than usual with no other symptoms, should consult with a physician.
  • Prostate. In men, prostatitis, or inflammation of the prostate, presses against the urethra and creates the urge to pee, and then prevents the individual from doing so. This is also a symptom of the more serious prostate cancer, meaning it is important for men to have their prostates examined frequently.
  • Chemotherapy. In many cases, urination during chemotherapy mirrors a UTI, with more frequent urges to pee, cloudy urine, and strange discoloration, as well as a very strong smell.
  • Pregnancy. The growth of a child in the uterus decreases space for other organs and especially presses on the bladder, meaning that it is quite likely a woman carrying a child will have more frequent urges to urinate.

Treatment for frequent urination

Since frequent urination is a symptom of some other condition, any treatment will be for that condition rather than the urge to pee. For example, someone with a UTI will likely be prescribed antibiotics to clear up the infection, and as the medication takes effect, the frequent urination will slow down. For someone with overactive bladder, on the other hand, it may require various therapies, including diet and exercise, lifestyle changes, and specific exercises (such as Kegels) to tighten the muscles around the urinary tract for greater control.


Needing to urinate constantly can be aggravating, and it can reduce a person’s quality of life, interrupting everything from work to social events and sleep. Exhaustion, inability to concentrate, and fear of being caught too far from a bathroom can also be emotionally stressful. Seeing a doctor to learn more about why this is happening can lead to a diagnosis and, in most cases, some form of treatment or therapy that reduces the impact of the problem and reduces the need to urinate so often.

Recurrent UTIs: Why Do I Get Urinary Tract Infections So Often?

The struggle and pain are real. Any woman or man who has suffered from a urinary tract infection knows it’s true. UTIs are annoying, painful, and they disrupt the flow of an individual’s everyday activities. In their worst stages, having reached the kidneys, they may even become debilitating. Having experienced one is enough. No one wants to go through that condition again. However, many will, especially women.

What is a recurrent UTI and what are the risks of getting them?

The luckiest individuals will never suffer from a urinary tract infection. Those that have had one consider themselves lucky to be among the ones who only get one. Yet, there are a large number of individuals who get them several times sometimes more than one in a month. An individual is considered to be having recurrent urinary tract infections if they suffer from two or more in six months that are documented by cultures.

An individual is at risk due to the following:

  • Age
  • Diabetes
  • Pregnancy
  • Bad hygiene
  • Genetics
  • Anatomy
  • Sexually active
  • Immune system compromise
  • Menopause
  • Former UTI

Recurrent UTIs are either due to a new bacterium entering the urethra or bacteria that was never eradicated from the urinary tract by the treatment an individual was given.

Most often, the infection comes from what is left behind after treatment. If an individual stops taking their medication because they “feel well” then the antibiotics are unable to finish their jobs. Some bacteria will remain, and a UTI will recur.

It is also a possibility that bacteria can lay dormant, or “hide”, from the antibiotics or even the urine test. Bacteria can group into clusters which form a shield, called biofilm, around themselves that makes them invisible in urinalysis and protected from antibiotics. Once the individual’s immune system is weakened by the antibiotics, these hidden fighters will emerge and run rampant. Since only free-floating bacteria can be found during testing, the individual may not even be diagnosed with a urinary tract infection in the first place.

Understanding the risks: Who is more likely to have recurrent UTIs?

As we age, our immune systems weaken. Infections of any type are more common, and often more detrimental to our health. Elderly people, mostly women due to hormone changes or giving birth, have weakened muscles surrounding their bladder. This condition may cause incontinence, inability to empty the bladder completely, and less flow of urine. All of these allow bacteria to cling to the bladder and grow. Menopause is also an issue for older females. Estrogen is reduced, and it is no longer a protection for the vagina. Many older individuals need catheters during or after surgery, or daily in order to release urine at all. Catheters irritate the urethra and bladder, and they may carry bacteria.

Diabetes can cause an individual to have nerve damage that can cause bladder dysfunction, or compromised blood flow to the urinary tract. Some of the medications that are taken for diabetes have specific side effects namely UTIs. These medications are meant to filter the sugar intake through the blood and release the access into the urine. Bacteria feeds on this sugar and uses it to grow. If the sugar infused urine dries outside the urethra it then becomes a gateway for bacteria to reach the urinary tract.

During pregnancy the uterus gets larger and may put pressure on the bladder. This can cause an obstruction, or even a blockage. Urine is then unable to flow properly, and the bladder never empties completely. As the urine sits in the bladder, bacteria clings to the walls where it grows and spreads.

Due to genetics, it is possible to be born with cells that may attract bacteria. This gives the bacteria that causes urinary tract infections namely E. coli an easy way to spread through the system.

A woman’s anatomy makes her more susceptible to UTIs. A female’s urethra is much shorter than a males, giving a shorter road to travel to the bladder. Worse yet, some women’s urethras are shorter than others. Add to that the fact that some women have wider urethras, and weaker muscles in that area, allowing for less flow of urine and a wider highway for bacteria. Lastly, a woman’s urethra is very close to her anus, where E. coli is commonly located in abundance.

Sexual activity allows the spread of bacteria. A woman and her partner should wash before sexual encounters as well as after. Urination immediately after sex can wash away bacteria before it becomes a problem. Always wash before switching from anal to vaginal sex.

Good hygiene is a must. Shower often, instead of bathing. Wear clean, cotton underwear. Wipe from front to back. Do not hold in urine and allow bacteria to grow.

If patients have a compromised immune system (HIV, multiple sclerosis, diabetes, chronic illness) they should speak with their doctor about preventative treatments.

What causes a burning sensation after urination when there is no infection?

A burning feeling after peeing is not always due to an infection. Sometimes, this symptom may have another cause.

The cause of a urinary tract infection (UTI) is usually bacteria from the body, rather than an external cause of infection. For example, bacteria from the bowel can cause this illness in the bladder, urethra, or kidneys.

Some less common conditions can also cause a burning feeling after urination when there is no infection present.

This article will look at the less common causes of UTI-like symptoms and explain when to seek medical help.

Share on Pinterest Urethral stricture disease, kidney stones, and other conditions may cause a burning sensation after urinating.

An injury or infection can cause urethral stricture disease. Stricture means a restriction or narrowing that happens when there is a blockage or partial blockage of the urethra.

Urethral stricture disease is more common in males because they have a longer urethra than females. The condition does not always have an obvious cause.

The urethra can become blocked or narrow due to:

  • a sexually transmitted infection (STI)
  • damage to the urethra because of an injury
  • swelling
  • surgery
  • recent catheter use

Alongside a burning feeling, the most obvious symptom is a reduction in the flow of urine. The problem usually goes away after an injury has healed, or the person has received treatment for an STI. Otherwise, surgery may be necessary to stretch the stricture.

Painful bladder syndrome is a condition that causes chronic pain, often without a clear cause. It can occur alongside other long-term conditions, such as fibromyalgia, irritable bowel syndrome (IBS), or vulvodynia. It is more common in females than in males.

As well as a burning feeling after peeing, other symptoms include bladder pain, a tender pelvic region, and the need to pee more often.

Painful bladder syndrome can make it more difficult for a person to socialize outside the home and to sleep. It can also cause pain during sex.

There is currently no cure for painful bladder syndrome, but treatment aims to relieve the symptoms. Treatment options include physical therapy, bladder training, lifestyle changes, and medication.

Prostatitis, which is inflammation of the prostate gland, affects males and can be painful.

A bacterial infection is a possible cause, but injury, muscle tension, or prostate stones can also be responsible for prostatitis. An injury or infection can cause swelling around the prostate that can affect the nerves and lead to pain.

Doctors usually treat infections with antibiotics. The treatment for other causes can include pain medication and prostatic massage, which is a specialized form of massage to drain fluid and reduce pressure.

In some cases, kidney stones can cause a burning feeling after peeing. A kidney stone can block the urethra and create a buildup of pee. Small kidney stones pass out of the body in the urine, and this can be painful.

Other symptoms include blood in the urine, pain on either side of the lower back, nausea or vomiting, and pee that is cloudy or smells bad.

Possible causes of kidney stones include too much salt and sugar in the diet, obesity, and not drinking enough water.

A person can drink more water to flush the kidney stone out of the body, but if a kidney stone is very large or causes an infection, surgery may be necessary.

Sometimes, a person experiencing a burning feeling after peeing may have other symptoms. These can include:

  • needing to pee more often
  • pain in the bladder, kidneys, or urethra
  • a reduced flow when urinating
  • urinary urgency, or a sudden need to pee
  • itching or irritation

If the person visits a doctor, they should make them aware of any additional symptoms to aid with the diagnosis.

A doctor will ask about the person’s symptoms and medical history. They may check for signs of fever or test for a UTI to rule this out as a cause. The most common test for a UTI involves a urine sample. Testing the sample for bacteria and white blood cells can show whether the body is fighting an infection.

Imaging tests can also help by giving a picture of the urinary tract and revealing any problems, such as a blockage or damage.

The doctor may also use a cystoscope, which is a camera on a long, thin tube. This device allows them to look inside the urethra and bladder for signs of infection.

Finding the underlying cause of a burning feeling after peeing is the first step. Treatment varies depending on the diagnosis.

While a person is waiting to see a doctor, they can ease discomfort at home by:

  • drinking plenty of clear fluids
  • avoiding caffeine and alcohol
  • drinking a sodium bicarbonate or potassium citrate beverage
  • taking ibuprofen
  • wearing breathable cotton underwear
  • avoiding delaying urination any longer than necessary

A person should consider seeking medical advice if a burning sensation when peeing lasts longer than a few days or if they also have:

These could be signs of more serious medical conditions, such as a kidney infection.

Older adults, children, and pregnant women should see a doctor if they have symptoms of a UTI.

It is also advisable for a person to visit a doctor if their symptoms return after treatment, or they have repeated UTIs.

A UTI can affect any part of the urinary tract, which includes the:

Females are more likely to develop a UTI than males because the female urethra is shorter.

A shorter urethra makes it easier for bacteria to reach the bladder, ureters, or kidneys, and research shows that about 40–60% of females will have a UTI at some point during their life.

The urethra is also closer to the anus, which contains bacteria that can cause a UTI.

Urethritis is the term for a UTI that only occurs in the urethra. Symptoms can include discharge, redness, and pain, as well as a burning feeling during or after peeing. However, some people will not experience any symptoms.

A burning feeling is usually a symptom of a problem somewhere in the urinary tract. Urethral stricture disease, prostatitis, and kidney stones are possible causes of this symptom, and they are all curable. Treatment can often relieve the symptoms of painful bladder syndrome if this is the underlying issue.

It could be beneficial for a person to pay attention to other symptoms and seek medical advice if a problem lasts for more than a few days.

If a UTI is present, most people will recover after treatment at home or with antibiotics. Some people experience repeated UTIs and may need to take regular medication.

Urinary Tract Infection (UTI): Symptoms & Signs

Symptoms of a urinary tract infection (UTI) are similar in men, women, and children. Early symptoms and signs are usually easy to recognize and primarily involve pain, discomfort, or burning when trying to urinate. Accompanying this can be the sense that one needs to urinate urgently (known as urinary urgency) or the need for frequent urination (called urinary frequency). Even when there is a strong urge to urinate, you may pass only a small amount of urine. The urine itself may appear bloody or cloudy. Men may feel pain in the rectum, while women may experience pain around the pubic bone.

Some people, however, may develop urinary tract infections without having these characteristic symptoms. Infants, in particular, may have nonspecific signs and symptoms like fussiness, fever, and poor feeding. Likewise, the elderly may not have specific symptoms, and the diagnosis may be more difficult in this case. In some cases, urinary tract infections can be present without causing symptoms at all.

In general, fever is uncommon if there is an infection of the bladder or urethra (lower urinary tract). Fever is more likely to accompany a UTI when the infection has spread to the kidneys or to the bloodstream.

Urinary tract infection (UTI) causes

A UTI occurs when bacteria enter and grow in the normally sterile urinary tract. At least 90% of uncomplicated infections are caused by a type of bacteria called Escherichia coli, better know as E. coli. These bacteria normally live in the bowel (colon) and around the anus and can move to the area around the urethra. Other types of bacteria can also cause a UTI but less commonly.

Related Symptoms & Signs

Other urinary tract infection (uti) symptoms and signs

  • Bladder Discomfort
  • Dribbling Urination (Passing Frequent Small Amounts of Urine)
  • Fever
  • Foul-Smelling Urine
  • Frequent Urination
  • Lower Abdominal Pressure
  • Painful Urination
  • Pelvic or Rectal Pain or Pressure
  • Persistent Urge to Urinate
  • Urinary Urgency

Symptom checker

Health concerns on your mind?
Click here to visit our Symptom Checker.

Main Article on Urinary Tract Infection (UTI) Symptoms and Signs

Several factors can contribute to the risk of urinary tract infection and they include:

  • pregnancy
  • sexual intercourse – it is a common cause of urinary tract infection in women since sex introduces bacteria into a woman’s urinary tract
  • catheterization
  • use of contraceptive spermicide
  • low levels of estrogen
  • immune suppression
  • wiping from back to the front following a bowel movement (in women and girls) can introduce bacteria into the urethra
  • people with diabetes – high glucose levels can make you more vulnerable to infection.

Note – UTIs in men are often related to an enlarged prostate blocking the flow of urine, which allows harmful bacteria to have an easier time occupying the urinary tract.

Management of UTI’s with Diabetes

Management of utis in people with diabetes is exactly the same, except you will be monitoring your blood sugars much more closely because you have an infection. As with any infection, we recommend that you check your blood sugar more frequently and contact the physician who manages your diabetes to let them know about your infection. You may need a temporary adjustment of your diabetes medications while you are sick.

If your blood sugars are very high, you run the risk of complications related to those high blood sugars even if you do not have Type 1 diabetes. Yes, people with Type 2 diabetes can be hospitalized for high blood sugars too!

If your blood sugar is over 250mg/dL this is considered too high and is at a dangerous level. Believe it or not, research shows you are actively doing damage to your body when your blood sugar is sustained at 150mg/dL 24 hours per day. Please contact your physician if your blood sugars start to rise if you get a UTI.

Different Types Of Chronic Urinary Tract Infection

Depending which country you are in, what your symptoms are, and which terminology your doctor is familiar with, you may have heard the following terms to describe different conditions of the urinary tract:

Chronic Urinary Tract Conditions: Different Names For The Same Family Of Problems

RUTIRecurrent Urinary Tract Infection
(Specifically, persistent recurrent infections)
Three episodes of a UTI in the previous 12 months or two episodes within the previous 6 months. RUTI can be classified as a persistent infection or a reinfection.

If you do a little research, you will quickly find there are also sub-categories within these conditions, with varying symptoms and levels of injury to the urinary tract.

It is not our intention here to imply these chronic urinary tract conditions are the same, or that they affect people in the same ways. But they do have an important thing in common – in the majority of cases, no cause has been identified, and the condition is therefore not curable. Treatment focuses on reducing symptoms rather than resolving the underlying issue.

“After about 3.5 years of chronic urinary tract infections, two doctors said they couldn’t help me further. A third said ‘maybe you just have irritable bladder or IC.’ That ‘maybe’ didn’t feel like a diagnosis. Why did my test results tell them nothing?”

So why do we mention these chronic urinary tract conditions?

There is strong evidence that many have been misdiagnosed with incurable conditions, when in fact they are afflicted with a chronic, embedded bladder infection that can be identified with appropriate testing, and treated effectively over time.

Treatment at UHS:

If you experience UTI symptoms, please get medical advice. Infections that are treated earlier will cause you less discomfort and are easier to treat.

First call UHS, which may save you a trip. Call 734-764-8320 day or night and ask for Nurse Advice. You will leave a message and a nurse will return your call, assess your situation by phone, and may prescribe medication, provide self-care advice, and/or arrange for you to visit to UHS.

For temporary relief of discomfort, a medication (called Uristat in non-prescription form and Pyridium by prescription) is available. This medication is not an antibiotic so will not cure a UTI. It should be used only until you are able to have a medical evaluation. This medication will cause urine and tears to turn orange. Women should not wear contact lenses while using this medication and should stop taking this medication 24 hours before any urine testing.

If you experience UTI symptoms after treatment, it's important to seek medical advice again because your infection may require additional testing, for example to make sure that infection is gone or to identify the type of bacteria causing infection, and treatment.