Women’s Health

Causes and treatment of recurrent urinary tract infections.

Causes and treatment of recurrent urinary tract infections.
Published : December 08 , 2020
Latest Update : August 24 , 2022
An obstetrician and gynecologist, holding the Jordanian board in obstetrics and gynecology. Member of the Jordanian society of obs and gyne. Has completed... more

Annually, more than 150 million people are diagnosed with Urinary Tract Infection (UTI).  A urinary tract infection is one that can affect different parts of your urinary system, including your bladder, urethra and kidneys. 

UTI is the most common infection in woman and it’s more common in women than in men because bacteria can reach the bladder more easily through the female body for two reasons:

Firstly, because the urethra (the opening to your urinary tract) is shorter in women than in men.

Secondly, the urethra is located near the rectum, making it easier to get contaminated. 

The good news? UTI can be easily treated with a course of antibiotics, however, it can be problematic if a woman gets a recurrent urinary tract infection. 

A recurrent UTI is defined as having three or more UTIs in 12 months. This diagnosis is usually confirmed by sending a urine sample to the lab for urine culture.

Causes

Urinary tract infections typically occur when bacteria enter the urinary tract through the urethra and ascends upward and multiply.

Although our body is designed to keep out such invaders, sometimes our defense mechanisms fail. When this happens, bacteria may invade and grow into an infection in the urinary tract.

Risk Factors

  • Female anatomy

    A woman has a shorter urethra than a man does, which shortens the distance that bacteria must travel to reach the bladder.
  • Sexual activity

      Sexually-active women tend to have more UTIs than women who aren't sexually active.
  • Kidney Stones

      Kidney stones can trap urine in the bladder and increase the risk of UTIs.
  • Menopause

     After menopause, a decline in the hormone estrogen causes changes in the urinary tract that make you more vulnerable to infection.
  • A suppressed immune system

      Patients with diabetes and other diseases that impair the immune system are at an increased risk.

So how can we reduce our chances of getting a UTI and a recurrent infection?

  • Drink plenty of liquids

    (especially water and cranberry juice). Drinking water helps dilute your urine and ensures that you'll urinate more frequently — allowing bacteria to be flushed out from your urinary tract before an infection can begin.
  • Wipe from front to back.

    Doing so after urinating and after a bowel movement helps prevent bacteria in the anal region from spreading to the vagina and urethra.
  • Empty your bladder soon after intercourse.

     Also, drink a full glass of water to help flush out the bacteria.
  • Avoid genital feminine products.

    Using some feminine products, such as douches and powders, in the genital area can irritate the urethra.

Treatment 

The treatment of a urinary tract infection usually involves a course of oral antibiotics. Which antibiotic and for how long to take it usually depends on the medical condition of the patient, the type or bacteria isolated in the urine culture, and if they have any complications.

Symptoms usually begin to improve within a few days of treatment and the patient should continue the whole course of antibiotic as prescribed by their physician. 

If the symptoms are more severe or some kind of resistant bacteria is present, the patient may need an intravenous antibiotic to eradicate it. 

Prophylactic measures against recurrent UTI

Clinicians may prescribe antibiotic prophylaxis to decrease the risk of future UTIs in high-risk women (those who have been previously diagnosed with UTIs).

Offering cranberry juice for women with recurrent UTIs can also be helpful. 

Sometimes you may need to take a longer course of antibiotics but in a lower dose, and this, again, depends on the case itself. 

Post-coital antibiotic prophylaxis is another effective measure to prevent UTIs in women when sexual activity usually precedes UTI.

In post-menopausal women with recurrent UTIs, doctors can recommend vaginal estrogen therapy to reduce the risk of future UTIs if there is no contraindication in estrogen therapy.

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