“Fake” UTIs: Alternative Facts or Reality?

**By Una Lee, MD**

Fake news has invaded our newsfeeds. There are even courses on how to tell fake news from legitimate news. But a fake urinary tract infection (UTI)? Is that even a thing? In fact, this fake is for real. A fake UTI is when a women (or man) experiences symptoms that seem exactly like a bladder infection, but are not caused by bacteria.  The fake version mimics a real UTI, but is not due to an underlying infection. It is more common for both real and fake UTIs to happen in women, but they can happen to men as well.

So what’s behind these fake UTIs? Sometime urinary symptoms like urgency, frequency, burning, urinary pain or discomfort are due to other causes, such as inflammation or irritation of the urinary tract. Increased sensitivity of the nerves that inhabit the urethra and bladder can occur when bladder irritants such as caffeine or alcohol, sexual activity, dehydration and stress are in the picture, or it can simply happen out of the blue. These ramped up nerve signals can cause the strong feeling like you have to urinate, even when your bladder is not full, and after you just went to the bathroom a few minutes ago.  These signals can also cause discomfort around that area of the body and can range from mild to horrible.

StormWhat can you do when this happens?  You can be evaluated for a real UTI, where a urinalysis and urine culture will determine if there’s been an overgrowth of harmful bacteria in your urine.  If the urine culture is positive, then appropriate antibiotics can be taken for treatment of a real UTI. However, when the urine culture comes back negative (even when it may have visually appeared positive), the patient may still be experiencing symptoms that are very real. I have discussed this phenomena with my patients who suffer from these fake UTIs, for which the suffering is not only real, but a frustrating event in their lives. Add to that a delay that sometimes occurs getting the results of a urine culture, and if it’s negative, the need for a solution intensifies.

Now the question is: how do you treat a fake UTI? The key is supporting your body so it can heal from what is an inflammatory process happening in your urinary tract. Your immune system can rise to the occasion if helped to do so, by alleviating the process at the root of the problem. Steps to take include increasing water intake; getting adequate, good-quality sleep; eating nourishing foods; managing one’s stress and avoiding activities that are irritating to this sensitive area of the body.

But beyond basic health measures, some women take probiotics, some of which are formulated to promote urinary health, that provide live microorganisms thought to be “good bugs.” Lactobacillus, the active cultures in yogurt, are another example of good bugs that may sound familiar, known to promote healthy intestinal flora. (But keep in mind: probiotics are largely unregulated by the U.S. Food and Drug Administration, and most lack proven scientific results.) Some women find whole cranberry or cranberry supplements helpful, as there are natural elements in cranberry that have been used for thousands of years to support urinary tract health. On the other hand, some women find cranberry juice and cranberry products irritating and it can make them feel worse.

For more immediate symptom relief, an old standby in your medicine cabinet may help. Pyridium also known as “Azo” (active ingredient is phenazopyridine) is a urinary analgesic that is an over-the-counter medication that turns your urine bright orange and can help take the discomfort away temporarily and help you get through the day. Some recent studies showed that ibuprofen worked as well as antibiotics in the treatment of uncomplicated UTIs, though women who took ibuprofen felt symptoms longer and showed an increased risk of kidney infection. But in the case of fake UTIs, ibuprofen could be helpful for reducing inflammation and associated symptoms. Not to mention that in this age of increasing resistance to antibiotics, we need to be judicious in their use. Antibiotics kill the bad bacteria and the good bacteria, disrupting the natural flora of our bodies. Understanding the delicate balance and function of microorganisms is important for maintaining our body’s natural defenses.

So if a fake UTI suddenly becomes a bigger problem in your life than fake news, know there are ways to fight back. Nothing is more real than your good health!

Lee_UnaUna Lee, MD is a urologist specializing in urogynecology at Virginia Mason Medical Center in Seattle. Dr. Lee says she is constantly inspired by the strength and resilience of women in her care. She hopes to alleviate the stress of conditions like real and fake UTIs by bringing a deeper understanding of these sensitive body parts.


  1. Nicholas says:

    Never knew this was a thing. This is a really nicely written article for fot pts and hcps alike. Thanks!

  2. Thanks. I love the content.

  3. Drink plenty of water! uti symptoms

  4. Julie Schmale says:

    You mentioned in your blog that recently Ibuprofen has proven to help with UTI’s. Have you heard chemically why that is? I ask this because since the release of ibuprofen back in the 80’s or 90’s, I have taken it 3 times (twice back then, once in 2005), and each time I get a UTI. Yes, it does just the opposite for me. My primary care provider thinks it must be because of something else, but the common denominator is always the ibuprofen.
    Have you had anyone with this issue, and if not, what do you make of it? Thank you for this much needed article!
    Thank you very much for your time.

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