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Recurrent Urinary Tract Infection (Recurrent UTI) or Chronic Urinary Tract Infection

WHAT IS A RECURRENT URINARY TRACT INFECTION (UTI)?

A urinary tract infection (UTI) is a bacterial infection in one or more parts of the urinary system: the kidneys, ureters, bladder or urethra. A urinary tract infection that occurs two or more times in a six month period is a recurrent urinary tract infection (also called a recurring UTI or a chronic urinary tract infection).

From the moment you contact Loma Linda University Health, we do everything we can to make sure your UTI treatment runs smoothly. Our goal is to make your experience as convenient, comfortable and stress-free as possible.

WHAT ARE THE SYMPTOMS OF A RECURRENT URINARY TRACT INFECTION (UTI)?

The symptoms of a urinary tract infection (UTI) include:

  • A strong urge to urinate
  • Frequent urination in small amounts
  • A painful burning sensation when urinating
  • Cloudy urine
  • Reddish pink, or brown urine
  • Urine with a strong unpleasant smell
  • Aching in the pelvis

If the urinary tract infection has spread to the kidneys, symptoms may include:

  • Nausea
  • Vomiting
  • Fever
  • Chills
  • Back pain below your ribs on either side of your body

A person who experiences two or more UTIs in a six month period or three or more UTIs in a 12 month period is experiencing a recurrent urinary tract infection.

WHAT CAUSES A RECURRENT URINARY TRACT INFECTION (UTI)?

Urinary tract infections are often caused when bacteria from the vagina or anus gets into and travels through the urinary system.

A common cause of a recurrent UTI is that some bacteria from a previous UTI may remain in the urinary tract system. In these cases, it may not have been completely eradicated the last time it was treated.

Another common cause of a recurring UTI could be related to your habits, such as:

  • Not urinating frequently enough to flush your system
  • Not urinating after sexual intercourse (especially for women)
  • Wiping incorrectly

HOW IS A RECURRENT URINARY TRACT INFECTION (UTI) DIAGNOSED?

Diagnosing a urinary tract infection is usually done by a simple urinalysis. In some cases, doctors may order additional tests, such as:

  • Blood tests
  • X-rays
  • CT scans
  • MRIs
  • Ultrasound of the urinary tract
  • Cystoscopy

HOW IS A RECURRENT URINARY TRACT INFECTION (UTI) TREATED?

There are a variety of effective ways to treat urinary tract infections:

Medications

For those with recurrent infections, taking a short course of antibiotics when each infection occurs is associated with the lowest antibiotic use. A prolonged course of daily antibiotics is also effective. Some recommend against prolonged use of antibiotics due to concerns of antibiotic resistance. Medications frequently used include:

  • Nitrofurantoin and trimethoprim/sulfamethoxazole (TMP/SMX)
  • Methenamine 
  • Antibiotics after intercourse - In cases where infections are related to intercourse, taking antibiotics afterward may be useful. 
  • Topical vaginal estrogen - In post-menopausal women, topical vaginal estrogen has been found to reduce recurrence.
  • Antibiotics following short term urinary catheterization - This appears to decrease the subsequent risk of a bladder infection. 

Alternative Medicine

The following remedies should be discussed with a medical provider:

  • Cranberry juice or capsules
  • Phenazopyridine  
  • Acetaminophen (paracetamol, Tylenol)
  • Asymptomatic bacteriuria
  • Uncomplicated UTIs
  • Fluoroquinolones
  • Amoxicillin-clavulanate

More severe UTIs may require hospital treatment, especially if the infection has spread to the kidneys.

WHAT ARE THE COMPLICATIONS OF A RECURRENT URINARY TRACT INFECTION (UTI)?

One serious complication of chronic urinary tract infection is damage to the kidneys. In this case, hospitalization may be required.

WHO IS AT RISK FOR RECURRENT URINARY TRACT INFECTIONS (UTI)?

Those most at risk of developing recurrent urinary tract infections include:

  • Women more than men
  • Menopausal and post-menopausal women
  • People who use catheters
  • People who suffer from diabetes, chronic illness, or a compromised immune system

NEXT STEPS

  • Be preventive. Your habits can help prevent urinary tract infections. Note the UTI causes listed above and take preventive action to avoid them.    
  • Seek medical intervention. If you are suffering from UTI symptoms, seek medical attention. To request an evaluation at Loma Linda University Health for acute or recurrent UTI symptoms, contact your provider or schedule the appointment through MyChart.