It is possible for someone to have a bladder infection, also known as a urinary tract infection (UTI), for months without realizing it. However, this would be considered an unusual and potentially dangerous situation. Most bladder infections cause symptoms like burning during urination, frequent and urgent need to urinate, foul-smelling urine, and pelvic pain within a few days of the infection developing. Ignoring these symptoms and not receiving treatment can allow the infection to worsen and spread to the kidneys, causing a more serious kidney infection known as pyelonephritis.
What is a bladder infection?
A bladder infection is an infection of the bladder and urinary tract, usually caused by bacteria. The urinary tract includes the urethra, bladder, ureters, and kidneys. When bacteria enter the urethra and travel upstream to the bladder, they can attach to the bladder wall and multiply, causing inflammation and infection. The medical term for a bladder infection is cystitis.
Bladder infections are extremely common, especially in women due to their shorter urethras. They occur when bacteria from the bowel or vagina get into the urinary tract. Some things that increase the risk for bladder infections include:
- Being female
- Sexual intercourse
- Using a diaphragm for birth control
- Going through menopause
- Having diabetes
- Having a urinary catheter
- Having anatomical abnormalities of the urinary tract
The most common cause of bladder infections is the bacteria Escherichia coli (E. coli), which normally lives in the bowel.
Common symptoms of a bladder infection
Bladder infections usually cause symptoms within a day or two of the infection developing. Common symptoms include:
- Burning with urination
- Increased frequency of urination
- Urgency to urinate
- Feeling unable to empty the bladder completely
- Cloudy, strong smelling, or bloody urine
- Pelvic pain or pressure
- Low back pain
- Feeling tired or shaky
- Fever and chills in some cases
The longer an infection goes untreated, the worse symptoms can become. Severe symptoms that may eventually develop include nausea, vomiting, flank pain, and high fever.
How could a bladder infection go undetected?
For someone to have a chronic bladder infection for months without realizing it would be very uncommon. There are a few reasons, however, that a chronic bladder infection could potentially go unnoticed:
- Mild or occasional symptoms that the person ignores or doesn’t recognize as a UTI
- Lack of typical UTI symptoms like burning urination
- Having an illness or condition that impairs the senses or dulls pain
- Advanced age, which may dull the senses
- Impaired mental function from conditions like dementia
- Poor access to medical care
Even without typical UTI symptoms, though, a chronic infection would usually cause eventual symptoms like fatigue, confusion, appetite loss, or high fevers indicating a kidney infection.
So while a mild bladder infection could potentially go undetected short-term, it would be very uncommon for someone to have an infection for months without some noticeable symptoms developing. Certain groups, like the elderly or mentally impaired, may be at higher risk for lacking awareness of symptoms.
Complications of an untreated chronic bladder infection
There can be serious consequences if a chronic bladder infection goes untreated:
- Spread to the kidneys – Bladder infections can travel up the ureters and infect the kidneys, called pyelonephritis. This causes symptoms like flank pain, fever, chills, nausea, and vomiting.
- Sepsis – An unchecked UTI can eventually spread to the bloodstream and cause a life-threatening widespread infection called sepsis.
- Permanent kidney damage – Recurrent kidney infections from untreated bladder infections can permanently scar and damage the kidneys, leading to chronic kidney disease.
- Increased resistance – Bacteria can become resistant to antibiotics if a chronic infection is not fully treated, making it harder to cure.
- Incontinence – Bladder infections can cause urge incontinence which may not fully resolve after the infection is treated.
- Pregnancy complications – UTIs during pregnancy increase the risk of low birth weight and premature delivery.
That’s why it’s critical to obtain medical treatment if a bladder infection is suspected or symptoms recur frequently. Catching and properly treating infections early is vital to prevent complications.
Who is at greater risk of an undetected chronic UTI?
Certain groups have an increased risk of having a chronic bladder infection go undetected:
- Elderly adults – Elderly individuals are more likely to have poor bladder control and difficulty emptying their bladder fully. They are also more prone to asymptomatic UTIs since their pain perception and urinary symptoms may diminish with age.
- People with diabetes – High blood sugar increases susceptibility to asymptomatic UTIs that can become chronic and harder to cure.
- People with spinal cord injuries – Those with spinal cord injuries often use catheters, have difficulty emptying their bladder fully, and may lack bladder sensation, increasing UTI risk.
- Immunocompromised patients – Individuals with weakened immune systems, like those with HIV/AIDS, cancer, or post-transplant, are vulnerable to more severe and persistent infections.
- Patients with indwelling catheters – People who use urinary catheters long-term have a higher likelihood of chronic asymptomatic UTIs developing.
- People with cognitive decline – Dementia, Alzheimer’s disease, and related disorders make it more likely that urinary symptoms will go unnoticed and untreated.
Doctors will have a higher index of suspicion for a chronic UTI in patients that fall into these high-risk groups, even in the absence of obvious symptoms.
Diagnosing a potential chronic bladder infection
If a chronic bladder infection is suspected, a doctor can use the following methods to diagnose it:
- Urinalysis – Testing a urine sample can detect traces of bacteria, white blood cells, and blood that would indicate infection.
- Urine culture – Growing the bacteria from a urine sample can identify the type of bacteria causing the infection.
- Cystoscopy – Viewing the inside of the bladder with a small camera inserted through the urethra can reveal inflammation or abnormalities.
- Ultrasound – Imaging tests check for bladder wall thickening, stones, benign tumors, or post-void residual urine volume.
- CT scan – A CT scan of the abdomen and pelvis provides images that may reveal urinary tract abnormalities, stones, or obstructions.
Based on test results, a doctor can diagnose a chronic UTI, rule out other bladder conditions with similar symptoms, and determine the appropriate antibiotic treatment.
Treating a chronic bladder infection
Treatment of a chronic or persistent bladder infection involves:
- Antibiotics – Usually a course of oral antibiotics for 7-14 days based on urine culture results. Longer courses up to 6 weeks may be needed for recurrent infections.
- Addressing any urinary obstructions – Any bladder stones, tumors, strictures, or prostatic enlargement that impair urine flow are treated.
- Improving bladder emptying – Techniques like intermittent catheterization, adjusting fluid intake, or medications can aid complete bladder emptying.
- Preventive antibiotics – Taking a low daily antibiotic dose may prevent recurrent UTIs in certain high-risk patients.
- Alternative therapies – Some patients use probiotics, cranberry pills, or D-mannose supplements to help prevent recurrent UTIs.
Identifying and addressing any complicating factors, like enlarged prostate or poor bladder emptying, is key to stopping recurring infections. A urology specialist can help manage difficult-to-treat recurrent UTIs.
Preventing chronic or recurrent bladder infections
To help prevent chronic or recurrent bladder infections:
- Urinate as soon as the need arises and empty the bladder fully
- Stay well hydrated to dilute urine and flush out bacteria
- Urinate shortly after intercourse to flush out bacteria
- Avoid using irritating feminine hygiene sprays or douches
- Wear cotton underwear and avoid tight-fitting pants
- Maintain good hygiene by wiping front to back after using the toilet
- Treat constipation and urinary incontinence which raise UTI risk
Getting prompt medical attention for suspected UTIs is also key before they can become chronic infections. Those prone to recurrent UTIs should stay in close contact with their doctor.
When to see a doctor
It’s important to contact a doctor if you experience any signs or symptoms of a potential UTI, such as:
- Burning sensation when urinating
- Frequent urination in small amounts
- Cloudy, strong smelling, or bloody urine
- Pelvic pain or back pain
- Feeling an urgent need to urinate
- Fever, chills, nausea, or vomiting
Seeking medical care right away allows proper diagnosis and timely antibiotic treatment to clear up the infection before serious complications develop.
Let your doctor know if you have frequent or recurrent UTIs requiring multiple courses of antibiotics, as a urology referral may be needed to evaluate for any underlying anatomical or functional issues with the urinary tract.
Conclusion
Having an undiagnosed chronic bladder infection for months is unlikely but can occur in certain populations like the elderly, people with spinal cord injuries, or those with cognitive difficulties. Typical UTI symptoms like painful urination usually drive most patients to seek treatment promptly before an infection becomes chronic. However, some people may only experience mild symptoms that they tolerate or adapt to, allowing an infection to persist.
Untreated chronic UTIs can have severe consequences like kidney infections, sepsis, kidney damage, and incontinence. That’s why it’s critical that those at high risk have regular urine testing to screen for asymptomatic infections. Diagnosing a chronic bladder infection requires tests like urinalysis, urine culture, and imaging. Treatment involves antibiotics, addressing urinary obstructions, improving bladder emptying, and preventive antibiotics in some cases.
While an undetected chronic bladder infection is uncommon, being aware of UTI symptoms and seeking prompt treatment is vital, especially for those at increased risk. This can prevent infections from becoming silently chronic and causing serious harm.