Uncomplicated vs Complicated UTIs – What’s the DIfference?

Uncomplicated vs Complicated UTIs – What’s the DIfference?

Urinary tract – any part of it can be affected by a UTI

What is an Uncomplicated UTI?

The term ‘uncomplicated UTI’ refers to an infection of the lower urinary tract (bladder/urethra) in an otherwise healthy individual with a normal urinary tract, who is non-pregnant and without significant comorbidities or anatomical abnormalities.

Key points

• It is typically a plain bladder infection (cystitis) in a healthy woman.
• The primary symptoms include burning on urination, frequency, urgency, lower tummy discomfort or suprapubic (lower tummy) pain.
• Because it is ‘uncomplicated’, the prognosis (outlook) is typically good and the management simpler.
• In the UK, this is commonly managed in primary care and through ‘pharmacy-first’ pathways for eligible patients.
• Most women aged 16–64 who are not pregnant should see a pharmacist first for a suspected uncomplicated UTI.

What is a Complicated UTI?

A complicated UTI refers to a urinary tract infection in a person with one or more risk factors that make it more likely to fail treatment, recur or spread to the upper urinary tract (e.g. kidneys).

Key points

Underlying causes, risk factors and clinical presentation that make a UTI ‘complicated’ include:

• Structural or functional abnormality of the urinary tract (stones, obstruction, neurogenic bladder)
• Presence of urinary catheter, recent urinary tract instrumentation or surgery.
• Pregnancy or immunosuppression.
• Male sex, older age (especially over 65 years), chronic kidney disease (CKD), diabetes or other comorbidities.
• Suspected upper tract (kidney) infection (pyelonephritis), or systemic signs (fever, chills, flank pain, sepsis).