Urinary tract infections: symptoms, when to see a doctor and what to watch for

Urinary tract infections are among the most common infections, particularly in women. The symptoms are usually recognisable and uncomfortable, and most people work out fairly quickly what is happening. What is not always obvious is when waiting is reasonable, when an assessment is needed, and when it is something more serious.

What a urinary tract infection is

A urinary tract infection is an infection of the urinary system. In the great majority of cases it affects the bladder and the urethra, the lower urinary tract. This form is also known as cystitis.

Less often, the infection travels upwards towards the kidneys. This is called pyelonephritis, it is a more serious condition, and it presents differently.

That distinction is the most important thing in the whole subject, because it changes entirely how urgent the assessment is.

The symptoms

In a lower urinary tract infection, the most common symptoms are:

• Burning or stinging when passing urine
• Needing to pass urine frequently, often only a small amount each time
• A strong, urgent need that is hard to postpone
• Discomfort or heaviness in the lower abdomen
• Cloudy urine or a strong smell
• Blood in the urine, which always needs assessment

Fever is usually absent or low in simple cystitis. When a high fever appears, the picture changes.

When it is worth speaking to a doctor

A medical assessment makes sense when:

• The symptoms are severe or are interfering with your day
• They have not settled within two days
• There is blood in your urine
• This is the first time you have had symptoms like this
• You have diabetes, kidney disease or a weakened immune system
• You are male, since urinary infections in men are always assessed
• Episodes keep coming back
• You need documentation for work

Most of these can be assessed well over a video call, because the assessment rests largely on the symptoms you describe, your history, and when they started. If you need to be seen the same day, you can book with a doctor who is available at that moment.

When you need urgent help

Some signs should not wait for a scheduled appointment. They suggest possible kidney involvement or a spreading infection and need immediate medical assessment.

Call 112, or 166 for an ambulance in Greece, or go to the emergency department of the nearest hospital, if you have:

• A high fever with chills
• Pain in the back or side, usually on one side
• Nausea or vomiting that stops you keeping fluids down
• Confusion or severe exhaustion, particularly in an older person
• Being unable to pass urine despite a strong urge
• Urinary symptoms during pregnancy

These cannot be assessed remotely.

How the assessment works

The doctor will ask exactly what you are feeling, when it started, whether there is a fever, whether you have back pain, what medication you take, whether you are pregnant, and whether you have had a similar episode before.

In many cases of uncomplicated cystitis in otherwise healthy women, the assessment rests mainly on that conversation.

A urine dipstick and a urine culture require a sample and a laboratory, so they cannot be done remotely. The doctor will tell you if they consider them necessary in your case and where you can have them done. A culture is particularly useful when episodes keep returning, or when symptoms are not settling as expected.

Antibiotics and urinary infections

Unlike sore throats and flu, a urinary tract infection is a bacterial infection, so an antibiotic has a genuine role in many cases.

When the doctor decides an antibiotic is needed, they can issue an electronic prescription through Greece's national ΣΗΣ system during the consultation, or a private prescription if you do not have an AMKA number.

That does not mean every discomfort when passing urine needs one. Similar symptoms can have other causes, and some mild episodes settle without treatment. Whether treatment is needed, which one and for how long are decisions the doctor makes based on your overall picture, your history and any previous cultures. The consultation fee covers the medical assessment itself, whatever its conclusion.

Taking antibiotics unnecessarily or incompletely contributes to antimicrobial resistance, which matters particularly in urinary infections, where resistance narrows the options available in later episodes. If you have been given an antibiotic, complete the course as prescribed and do not use leftovers from a previous time.

What helps at home

Alongside whatever the doctor recommends:

• Drink enough fluids, so that you pass urine regularly.
• Do not put off passing urine when you feel the need.
• Pain relief, following the instructions on the packet or your pharmacist's advice.
• Avoid irritants such as perfumed products in the area.
• Rest, particularly if there is a fever.

For cranberry products and various supplements, the evidence is limited and inconsistent. They do not replace a medical assessment when one is needed.

Urinary infections in pregnancy

In pregnancy, urinary infections are treated with greater caution, even when symptoms are mild or absent.

The reason is that an undiagnosed infection can progress and affect both the pregnancy and the kidneys. Assessment is therefore done early and usually includes laboratory testing.

If you are pregnant and develop urinary symptoms, speak to a doctor without delay.

Urinary infections in men and children

In men, urinary infections are considerably less common, which is why they are always assessed. The doctor considers whether there is an underlying factor making them more likely, and often requests laboratory testing.

In children the symptoms are not always clear. A young child may have only an unexplained fever, reduced appetite, irritability, or wetting accidents when that was not happening before. Any suspected urinary infection in a child needs a medical assessment.

A parent or guardian books the appointment and stays with the child throughout the consultation.

When episodes keep returning

Some women get urinary infections repeatedly within the same year. When that happens, the question is no longer about the individual episode but about the pattern.

It is worth writing down how many episodes you have had, when, what symptoms each involved, whether a culture was done and what treatment was given. That picture guides the discussion more than anything else.

The doctor will explain what can be evaluated further and whether assessment by a urologist is needed.

Frequently asked questions

Do I always need an antibiotic for a urinary infection? Not necessarily. Many cases need treatment, but not all, and similar symptoms can have another cause. Whether one is needed is decided by the doctor, and if it is, a prescription can be issued during the consultation.

Can a urine test be done remotely? No. A dipstick and a culture require a sample and a laboratory. The doctor will tell you if they consider them necessary.

How quickly do symptoms settle? When treatment is given, symptoms usually begin to improve within a few days. If they are not improving, or are getting worse, a reassessment is needed.

Is blood in the urine always concerning? It always needs assessment. It occurs in urinary infections but also in other conditions, which is why it is not ignored.

Can this be assessed by video call? In many cases yes, particularly for uncomplicated episodes. If laboratory testing or a physical examination is needed, the doctor will explain this.

Can the doctor give me a sick note for work? The doctor can issue a sick note where they consider it clinically appropriate, based on the assessment.

If you have urinary symptoms and want to talk them through, you can do so without leaving the house. See how telemedicine in Greece works, or download the DocNow app, choose an available doctor and book your appointment. Each consultation is scheduled for 15 minutes and costs a flat €20. The doctor will assess your case and explain the appropriate next steps, at their clinical discretion.

Appointment availability depends on doctor availability at the time of booking.

The information above is provided exclusively for educational purposes and does not replace medical advice. Please consult your treating doctor to determine the most appropriate treatment plan for your individual needs.