Are Bladder Infections and UTIs the Same Thing?

November 2, 2022

Bladder infections are among the most common causes of sepsis. So what can you do to protect yourself from a bladder infection, the most common type of urinary tract infection (UTI)? November is National Bladder Health Month, a good time to learn about bladder infections and how to decrease your chances of getting one.

What is the difference between a UTI and a bladder infection?

The urinary tract is the system that starts at your kidneys and ends at your urethra, where your urine drains from the bladder. The term UTI refers to an infection anywhere in the urinary tract. A bladder infection, called cystitis, is just in the bladder. But since the bladder is part of the urinary tract, it is sometimes called a UTI.

Isn’t urine sterile? How can it cause an infection?

It may seem puzzling to some that UTIs are so common. After all, isn’t urine sterile? Actually, it’s not – that’s an urban legend. The “urine is sterile” myth seems to have started in the 1950s when a physician from Harvard Medical School tried to find a reliable way to check for UTIs in patients who were about to have surgery. The urine samples he looked at didn’t have enough bacteria to cause an infection, but people took that to mean that there were no bacteria in the urine. They then said that urine was sterile. Further research showed that urine does contain bacteria, and as long as they stay at very low levels, they don’t cause infections.

So how do infections start then?

Bacteria live all over your body. Most are harmless, and some are helpful. The few bacteria that can make you sick do so when they enter your body. Bacteria can easily enter the urethra from the vaginal, genital, and anal areas through sexual activity or wiping after a bowel movement, for example.

About one in five people with short urethras (cisgender women and transgender women who have had vaginoplasty) have at least one UTI in their lifetime – many more than once. Shorter urethras mean the bacteria have less distance to travel into the urinary tract.

Cisgender men and transgender men who have had a phalloplasty can also develop UTIs, but it’s not as common because the bacteria have farther to travel. Their risk rises as they age, particularly if they have a prostate. An enlarged prostate can block or slow urine flow from the bladder, allowing bacteria to multiply in the remaining urine and cause an infection.

What are some bladder infection symptoms?

If you have had one bladder infection or UTI, then you probably will instantly recognize a second one. The most common symptoms include:

  • A strong, persistent need to urinate (called urgency)
  • Needing to urinate frequently, but only small amounts appear (called frequency)
  • Pain or burning as you urinate
  • Cloudy or bloody urine
  • Foul-smelling urine
  • Pain or pressure in your lower abdomen
  • Low-grade fever

In some cases, there are no symptoms until the infection causes sepsis. While this can happen at any age, it is not uncommon among the elderly. Sometimes healthcare professionals only detect an infection when someone develops sudden confusion or a worsening of already present dementia.

How is a bladder infection diagnosed and treated?

Diagnosing a bladder infection is pretty straightforward most of the time. Your doctor or nurse practitioner will probably want a urine test, called a urinalysis, based on your symptoms. This shows if there are signs of an infection, including blood that may not be visible, and bacteria.

Bacterial infections are treated with antibiotics. The type of antibiotic and how long you have to take it can depend on if this is your first UTI or if you have had others. Whatever antibiotic you get, be sure to take it according to directions and for the full time, even if you are feeling better. The symptoms may be gone, but the bacteria are likely still there. Taking antibiotics improperly or stopping them too soon contribute to the rise of antimicrobial resistance. This occurs when bacteria and other microbes become resistant to the medications that are used to kill them.

Ask your doctor or pharmacist how long it should take to start feeling relief from the infection. If you don’t start feeling better by then, contact your doctor or nurse practitioner because you may need a different medication.

Can bladder infections be prevented?

We can’t always prevent a bladder infection, but there are many steps you can take to reduce your risk:

  • Don’t let urine sit in your bladder for extended periods. Don’t ignore the urge to urinate.
  • Keep hydrated. Drink fluids so your urine doesn’t get too concentrated.
  • After having a bowel movement, wipe from front to back.
  • Be gentle when you wash your genitals. Avoid harsh cleansing and scented products.
  • Urinate after sex.
  • People who have frequent UTIs, consider taking showers instead of tub baths.


If you have a bladder infection, watch for signs of sepsis, even while taking antibiotics. If you suspect you may have sepsis, seek immediate help.

To learn more about bladder infections, visit Sepsis and Urinary Tract Infections, part of the Sepsis and… library. You can also read Faces of Sepsis stories from people who developed sepsis from a UTI here.