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Recurrent UTI refers to getting at least 2 infections in six months or at least 3 infections in one year.

The episode of UTI must be confirmed with positive urine culture.

Is this common?

Recurrent UTI is one of the most common condition affecting mainly women.

It is estimated that around 50–60% of women will develop UTIs in their lifetimes and Escherichia coli is the most common organism that causes UTI.

Are they different types of UTI?

UTI can be divided into 2 board categories: Uncomplicated and complicated

Uncomplicated UTI is when the patient suffers from an isolated episode of UTI without any is one structural or functional abnormalities of the urinary tract.

Complicated UTI is when UTI occurs in patients with existing structural or functional abnormalities of the urinary tract such as urinary obstruction due to prostate, or in patients with injury to the spine.

Is recurrent UTI related to sex?

Yes. Sexual intercourse and the use of spermicide can be the cause of recurrent UTI especially in young and pre-menopausal women.

What are the other causes of recurrent UTI?

Am I genetically at risk of getting recurrent UTI?

Yes, it is possible. The different blood groups secretor substances may influence the availability of these receptors on the urothelial cells (cells on the surface of the bladder) thereby affecting bacterial adherence and the susceptibility to UTI.

The frequencies of secretor status in different ABO blood groups are 70.1% in group A, 67.8% in group B, 67.9% in group AB, and 88.3% in group O.

Hence blood group B and AB individuals are at risk of getting recurrent UTI.

What should I expect at my first visit to a Urologist?

Your Urologist will first take a history, perform physical examination and do a series of tests to establish the diagnosis of recurrent UTI. These may include:

  • Midstream urine analysis
  • Urine Culture and Sensitivity analysis of the bacteria involved
  • Bedside ultrasound examination of the kidneys and bladder
  • Uroflowmetry and post void residual urine

Depending on your symptoms, further tests such as CT scan or Cystoscopy might be offered by the Urologist.

The purpose of these tests is to exclude any organic causes to the recurrent nature of the UTI. These include stones, downstream obstruction such as prostate enlargement or by prolapsed organs (women) and most importantly to rule out underlying cancers that could account for the symptoms.

What is the treatment for recurrent UTI?

Generally, the treatment for recurrent UTI can be divided into three board categories

  • Conservative

Prevention is better than cure!

  • Drink plenty of fluids
  • To urinate regularly
  • Not to holding urine for a long time . This allows bacteria to multiply within the urinary tract, resulting in UTI.
  • Pass urine after sexual intercourse
  • Avoid spermicidal contraceptives if possible, diaphragms and vaginal douching with shower cream, soap or lotions. This will irritate the vagina and urethra area and facilitate the entry and colonisation of bacteria. They could alter vaginal flora and cause UTI.
  • To wipe from front to back, which will reduce the spread of E. coli from the perigenital area to the urethra.
  • Avoiding multiple sexual partners will reduce the risk of both UTIs and sexually transmitted infections.
  • Cranberries and Probiotics have been proven effective in preventing recurrent UTI in small studies.
  • Vaginal estrogen creams or rings may also reduce the risk of UTI in postmenopausal women

Antibiotics

  1. Self-start regime
    If you are familiar with the symptoms and it has proven with a urine culture before, the urologist may advise you to self start antibiotic treatment whenever you are experiencing the start of the UTI symptoms.
  2. Post sexual intercourse self-start
    If the UTI happens mostly after sexual intercourse, your Urologist may advise you to self start a 3-day prophylactic course of antibiotics after sexual intercourse.
  3. Long term low dose antibiotic regime
    Your urologist may advise you to take a 3 to 6 month daily course of low dose antibiotics to prevent recurring UTI. This is usually advised when all conservative measurements fail.
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