Can Uterine Fibroids Cause A Urinary Tract Infection?

Uterine fibroids do not directly cause urinary tract infections, but they can create conditions that make them more likely. Large fibroids can press on your bladder and urethra, which may prevent your bladder from emptying fully. When urine stays in the bladder longer than it should, bacteria have more time to multiply and cause an infection. The connection is real, but it is indirect — fibroids change how your urinary system works, and that change increases your risk.

How Fibroids Affect Your Bladder and Urinary Tract

Fibroids are non-cancerous growths that develop in or on the uterus. Depending on their size and location, they can take up significant space in your pelvis. Your bladder sits directly in front of your uterus. When a fibroid grows large enough, it can push against the bladder from behind.

This pressure does two main things. First, it reduces the bladder’s capacity to hold urine comfortably. You may feel the urge to urinate more often, sometimes urgently. Second, and more importantly for infection risk, the pressure can physically distort the bladder’s shape. A compressed bladder may not empty completely when you urinate.

This condition is called urinary retention, and even partial retention matters. Normal urination flushes bacteria out of the urethra and bladder. When some urine remains behind, bacteria that enter the urethra have a warm, moist environment to grow in. Over hours and days, that small amount of residual urine can turn into a full-blown infection.

What the Research Shows About Fibroids and UTIs

Clinical studies have examined this connection, but the evidence is not as strong as you might expect. Some research suggests that women with fibroids do experience higher rates of urinary tract infections. Other studies have found no significant increase in UTI risk among women with fibroids. The difference likely comes down to fibroid size and position.

Small fibroids that stay within the uterine wall rarely affect the bladder at all. Subserosal fibroids, which grow on the outside of the uterus toward the bladder, are more likely to cause pressure symptoms. Large fibroids — roughly the size of a grapefruit or larger — are the ones most often associated with urinary problems.

A 2017 study published in the International Urogynecology Journal found that women with fibroids reported more urinary symptoms than women without them. However, the study focused on symptoms like frequency and urgency, not confirmed infections. The distinction matters. Feeling like you need to urinate often is not the same as having a bacterial infection.

Other Urinary Symptoms Fibroids Can Cause

Fibroids can produce several urinary symptoms that feel like a UTI but are not. This is a common source of confusion. Women sometimes assume they have an infection because they are running to the bathroom constantly, only to have a urine test come back negative.

• Urinary frequency — needing to urinate more than eight times a day
• Urgency — a sudden, strong need to urinate that is hard to delay
• Nocturia — waking up at night to urinate
• Incomplete emptying — feeling like the bladder is not fully empty after urinating
• Difficulty starting urination — hesitancy or a weak urine stream

These symptoms can occur without any bacteria present. The fibroid is physically irritating the bladder wall or compressing the urethra. If you have these symptoms but a negative urine culture, the problem is mechanical, not infectious. That distinction changes the treatment approach completely.

When Is It a UTI and Not Just Fibroid Pressure?

A true urinary tract infection involves bacteria. The hallmark signs are different from simple pressure symptoms. Burning or pain during urination is the most reliable indicator. Cloudy urine, strong-smelling urine, and pelvic discomfort are also common. Some women experience lower abdominal pain that feels different from fibroid-related pressure.

Fever is a red flag. A fever with urinary symptoms suggests the infection may have reached the kidneys, which is a more serious condition called pyelonephritis. This requires prompt medical attention.

The only way to confirm a UTI is a urine test. Your doctor will check for nitrites and leukocyte esterase on a dipstick, then send the sample for culture if the dipstick is positive. The culture identifies the specific bacteria and determines which antibiotics will work.

If you have fibroids and suspect a UTI, do not assume the symptoms are just fibroid pressure. Get tested. Untreated UTIs can spread to the kidneys and cause lasting damage.

Can Treating Fibroids Reduce Your UTI Risk?

If your UTIs are genuinely linked to fibroid-related urinary retention, treating the fibroids may help. The evidence here is limited but logical. Removing or shrinking a fibroid that is compressing your bladder should restore normal bladder emptying. With normal emptying, the bacterial growth environment is eliminated.

Treatment options range from medication to surgery. Gonadotropin-releasing hormone agonists can temporarily shrink fibroids by reducing estrogen levels, but they are not a long-term solution. Uterine fibroid embolization cuts off the blood supply to fibroids, causing them to shrink. Myomectomy surgically removes fibroids while preserving the uterus. Hysterectomy removes the uterus entirely.

Each option has different risks, recovery times, and implications for future fertility. The choice depends on your symptoms, fibroid size and location, your age, and whether you plan to have children. Discussing your specific situation with a gynecologist is the only reliable way to determine the right approach.

No high-quality trials have directly compared UTI rates before and after fibroid treatment. Some clinicians report improvement in urinary symptoms after fibroid removal, but this is based on clinical experience rather than controlled studies. The reasoning is sound — relieve the pressure, restore normal function — but it has not been rigorously proven.

Practical Steps to Lower Your Risk Right Now

Whether or not you treat the fibroids, you can take steps to reduce your UTI risk. These strategies are well established and work regardless of the underlying cause.

Stay well hydrated. Drinking enough water dilutes your urine and increases urination frequency, which flushes bacteria out of the urinary tract. Urinate when you feel the urge — holding it gives bacteria more time to multiply. Urinate shortly after sexual activity to flush any bacteria that entered the urethra during intercourse.

Wipe from front to back after using the toilet. This prevents bacteria from the anal area from being introduced to the urethra. Avoid using douches or heavily scented feminine products in the genital area, as these can irritate the urethra and disrupt the natural bacterial balance.

If you have fibroids and experience frequent UTIs, ask your doctor about checking your post-void residual volume. This simple ultrasound test measures how much urine remains in your bladder after you urinate. A high residual volume confirms that incomplete emptying is part of your problem. Knowing this helps your doctor recommend the most appropriate treatment.

When to See a Doctor

See a doctor promptly if you have symptoms of a UTI, especially if you have known fibroids. Burning with urination, fever, or flank pain warrants medical evaluation. Do not wait to see if the symptoms resolve on their own.

If you have fibroids and recurrent UTIs — defined as two or more infections in six months or three in a year — ask for a referral to a gynecologist. The combination of fibroids and recurrent infections deserves coordinated evaluation. Your gynecologist can assess whether the fibroids are contributing to your urinary problems and discuss treatment options.

Also seek medical advice if your fibroid symptoms are worsening. Heavy bleeding, severe pelvic pain, or a noticeable increase in abdominal size all warrant evaluation. These symptoms may indicate fibroid growth that could eventually affect your urinary system even if it has not yet.