How to Manage Recurrent UTIs Like an Expert?

Urinary tract infections are no fun. They are painful and worrisome, especially when they keep coming back after treatment. Learn how you can shake off these common but annoying infections and improve your urinary health.

What Are Recurrent UTIs?

If you have been diagnosed with at least two UTIs in a period of six months or three UTIs in 12 months, you have recurrent UTIs. This is a common and frustrating situation, particularly for women. Estimates suggest that more than 50% of women experience at least one UTI in their lifetime, and 26% of women experience a recurrence within six months. The risk increases with age. In one study, 53% of women aged over 55 and 36% of younger women had a UTI recurrence within one year of the initial infection [1].

Finding an effective way to manage recurrent UTIs may require a combination of methods. Prescription medications, over-the-counter remedies, and lifestyle measures can all help reduce the risk of recurrent UTIs. 

Risk Factors for Recurrent UTIs

Anyone can get a UTI. They happen when harmful bacteria enter the urinary tract and cause an infection. Most UTIs are caused by E. coli, which is a type of bacteria present on the skin around the urinary tract. When E. coli or other bacteria infect the bladder, urethra, ureters, or kidneys, it can cause pain, inflammation, fever, painful urination, or blood in the urine. 

The risk of recurrent UTIs can increase due to certain health conditions or lifestyle factors, including [2]: 

• Spermicide use 
• Atrophic vaginitis
• Chronic diarrhea
• Malformation of the urinary organs
• Pelvic organ prolapse 
• First UTI prior to age 16 
• Genetic predisposition 
• Frequent sexual intercourse
• Incomplete bladder emptying
• Inadequate fluid intake
• New or multiple sexual partners
• Urinary incontinence

‍

‍

Since the bacteria that cause many UTIs are transferred from the skin around the genitals or the hands, personal hygiene behaviors, such as wiping from back to front or not washing hands before touching the genital area, can also increase the risk of recurrent infections.

Medical Treatment for Recurrent UTIs

Most UTIs require antibiotics to treat the infection, which your primary care doctor can easily provide. However, if you have recurrent UTIs, you may need to visit a specialist, such as a gynecologist or urologist, who has additional expertise in treating pelvic organs. 

With an uncomplicated UTI, many doctors presume that E. coli causes the infection and prescribe a medication that is effective at killing that particular bacteria. However, repeated courses of the same antibiotic may not be effective at managing recurrent UTIs. This is because many recurrent urinary tract infections are new infections caused by different bacterial organisms [3]. 

In the case of a UTI occurring shortly after a previous infection, it's important to ask for a urine culture to identify the bacteria causing the infection. Dipstick tests can identify the presence of bacteria but don't specify which bacteria are present. A urine culture is a lab test to grow and examine the bacteria under a microscope to determine its type [4].

Once your doctor identifies the specific cause of the infection, they can prescribe the proper antibiotic. 

In some cases, your doctor may suspect a physical issue that leads to UTIs. A bulge or prolapse of any organ in the pelvic region or a malformation within the urinary tract can trap bacteria and lead to infections. If your doctor is concerned about an anatomical cause, they may need to perform a pelvic exam or order imaging such as an ultrasound to identify the problem.