Urinary Tract Infections (UTIs) occur when bacteria—most commonly Escherichia coli (E. coli)—enter and multiply in parts of the urinary system such as the bladder (cystitis), urethra (urethritis), or kidneys (pyelonephritis). While many UTIs are isolated events, some individuals experience repeated episodes over a short period—this is known as recurrent UTI.
You may be at risk if:
• You are female (shorter urethra)
• You are postmenopausal (low oestrogen thins urinary tract tissues)
• You have diabetes, kidney stones, or a weakened immune system
• You use spermicides or diaphragms
• You have frequent sexual intercourse (“honeymoon cystitis”)
Common Causes of Recurrence
- Incomplete Eradication: Bacteria not fully cleared by prior antibiotics.
- Anatomical Factors:
Bladder prolapse
Urethral strictures
Residual urine after voiding - Behavioural Triggers:
Dehydration
Delaying urination
Wiping back-to-front
Spermicide use - New Infections: Re-exposure to bacteria.
Diagnosis & Testing
Your gynaecologist may recommend:
- Urine Culture: Identifies bacteria and antibiotic sensitivity.
- Imaging: Ultrasound/CT to check for stones or structural issues.
- Cystoscopy: Camera exam of the bladder (if structural problems suspected).
- Post-void Residual (PVR) Test: Measures urine left in the bladder after voiding.
Management & Treatment
1. Acute Infection Treatment
- Antibiotics: 3–7-day course based on culture results.
- Symptom Relief:
- Phenazopyridine (for burning/pain)
- Hydration (2–3L water/day)
- Heat pads for cramping
2. Prevention Strategies
- Lifestyle Changes:
| Do | Avoid |
| Wipe front-to-back | Spermicides/douches |
| Urinate after sex | Tight synthetic underwear |
| Drink 6–8 glasses of water/day | Dehydration |
- Medical Prevention:
- Low-dose antibiotics: Take nightly or post-sex (e.g., nitrofurantoin).
- Vaginal Oestrogen: (Postmenopausal) Restores protective vaginal flora.
- Probiotics: Lactobacillus strains (oral/vaginal) support healthy flora.
Risks of Untreated rUTIs
- Kidney infections (pyelonephritis)
- Sepsis (life-threatening)
- Kidney scarring
Frequently Asked Questions
Q: Are rUTIs my fault?
A: No! Anatomy, genetics, and medical history play key roles.
Q: Can cranberry juice prevent UTIs?
A: Evidence is mixed. Concentrated cranberry capsules may help, but juice is high in sugar.
Q: Do I need antibiotics forever?
A: Usually short-term (6–12 months). Many transition to non-antibiotic strategies.
Q: Can my partner reinfect me?
A: Rare – UTIs aren’t sexually transmitted, but sex can introduce bacteria.
Q: Does menopause increase UTI risk?
A: Yes – vaginal oestrogen reduces risk by 50–75%.
eGynaecologist Advice:
- You must seek gynaecological consultation if you suspect recurrent urinary tract infections are associated with menopausal symptoms.
- You should seek immediate gynaecological consultation if your urine infection is complicated with back/flank pain, nausea or vomiting, blood in urine or confusion, especially in elderly.
