Recurrent UTI: Symptoms, Causes and Treatment

Recurrent Urinary Tract Infections (UTIs) can be frustrating and bothersome. After experiencing their first UTI, 27% of women have a confirmed recurrence within the next 6 months. While most UTIs respond well to antibiotics, some can persist and affect overall well-being.

However, they can be effectively managed with targeted treatments and preventive measures. In this article, we will explore recurrent UTIs, their symptoms, causes, treatment, and preventive measures available for managing this condition.

Understanding recurrent UTI

If you have just a single occurrence of UTI after the first one in years and think it’s a recurrent UTI, you are wrong. Recurrent UTIs refer to the occurrence of 3 or more infections within 12 months or 2 infections within 6 months. 

Both men and women can experience recurrent UTIs, but they are more prevalent in women. This disparity is primarily due to anatomical differences between male and female urinary systems, particularly the shorter urethra in women, facilitating easier access for bacteria to reach the bladder. 

Additionally, other factors like hormonal changes (low Estrogen) and aging connective tissue (urinary incontinence, pelvic organ prolapse) can also contribute to the higher incidence of UTIs in women.

Symptoms of recurring UTI

Recurrent UTI is usually characterized by the following symptoms:

Dysuria

Dysuria refers to pain, burning, stinging, or itching of the urethra or urethral opening during urination. The primary infectious cause of Dysuria is a Urinary Tract Infection (UTI).

Blood in urine (Hematuria)

Another symptom of recurrent UTIs is blood in your urine, known as Hematuria. Hematuria can appear as pink, red, or tea and cola-colored urine, indicating the presence of red blood cells. This symptom can be a sign of irritation or damage to the urinary tract, which can occur with frequent infections. Hematuria should not be ignored, as it can signal more serious underlying issues.

Urinary frequency

One of the primary indicators of a recurrent UTI is a sudden increase in the frequency of urination. You may feel an urgent need to urinate even when your bladder is not full. However, when you do pass urine, only small amounts may be released.

Other symptoms

You can also have the following symptoms of UTI:

• Lower abdominal, side, or back discomfort.
• Feeling extremely tired (Fatigue) 
• Feeling achy and tired
• A high fever of 38ºC (100.4ºF) or above 
• Shivering and chills 

Causes of frequent UTI

Several factors contribute to getting recurrent UTI, including:

• Reinfection: Bacteria from the initial infection may persist in the urinary tract or surrounding areas by forming clusters inside cells, leading to reinfection
• Antibiotic resistance: Frequent or prolonged antibiotic use can promote the development of antibiotic-resistant bacteria, making future UTIs more challenging to treat
• Bladder emptying issues: Incomplete bladder emptying, due to conditions like Urinary Retention or bladder dysfunction, leaves residual urine that allows bacteria to multiply, raising the risk of UTIs
• Kidney stones: Kidney stones can obstruct the urinary tract, trapping bacteria and causing irritation, which makes it easier for infections to develop and persist
• Physical factors: Physical factors, such as structural issues in the urinary tract can increase the likelihood of recurrent or chronic UTIs
• Hormonal changes: Hormonal changes, especially during Menopause, can make the vaginal and urinary tract prone to UTIs

Treatment Options

A personalized approach is essential for treating recurrent UTIs. Treatment options may include:

Antibióticos

A course of antibiotics is usually prescribed to treat recurrent cases of acute UTIs. Augmentin 375, a combination of Amoxicillin and Clavulanate, effectively kills bacteria and prevents resistance.

Also read: Read Choosing Right Antibiotics for UTI: A Guide to Effective Treatment to learn more about some of the best antibiotics for various bacteria in UTI.

Estrogen therapy

To treat recurrent UTI in postmenopausal females, local Estrogen therapy can be prescribed. It may include:

• Vaginal creams
• Vaginal rings
• Tablets 

These may help to restore the natural protective vaginal flora, reducing the risk of UTIs.

Immunotherapy

Immunotherapy may be recommended in some instances to boost the immune system’s ability to fight off infection. It is particularly relevant when there is an evident immune deficiency or when the UTIs are caused by antibiotic-resistant bacteria. 

Additionally, individuals with recurring UTIs and underlying medical conditions that compromise their immune system, such as Diabetes or HIV/AIDS, may benefit from immunotherapy.

How to prevent frequent UTI

Preventing recurrent UTIs is crucial for individuals who have experienced multiple infections. Here are some preventive measures that can be taken:

• Hydration: Drinking enough water helps flush bacteria from the urinary tract, reducing the risk of UTIs
• Do not hold Urine:Avoiding holding urine for extended periods is important, as it can allow bacteria to multiply, potentially leading to UTIs
• Practice good hygiene: When using the toilet, wipe from front to back to avoid bacteria from the anal region entering the urethra
• Pee after sex: Urinating shortly after sexual intercourse can also help flush out the bacteria that may have entered the urethra, preventing the risk of having a UTI
• Cranberry products: Some evidence indicates that cranberry products, like juice or supplements, may help prevent UTIs by stopping bacteria from sticking to the bladder walls
• Probiotics: Certain probiotics, such as Lactobacilli, can help preserve a healthy balance of bacteria in the urinary and vaginal tracts, reducing the likelihood of UTIs

Conclusion

Recurrent Urinary Tract Infections can be particularly frustrating and disruptive, especially for women.

Various factors contribute to recurrent UTIs, including reinfection, antibiotic resistance, anatomical abnormalities, hormonal changes, and weakened immune systems. Treatment approaches may involve antibiotics, Estrogen therapy for postmenopausal females, and immunotherapy in some instances. 

Staying hydrated, urinating regularly, maintaining good hygiene, and using cranberry products and probiotics can help lower the risk of UTIs. By adopting these practices, individuals can proactively maintain their urinary tract health and overall well-being.

Frequently Asked Questions

• pubmed.ncbi.nlm.nih.gov
• urologyhealth.org