Why do I get recurrent UTIs?

Recurrent UTIs are an annoying and painful condition that can have numerous different causes. In her latest article, revered obstetrician-gynaecologist Ms Sameena Muzaffar explains the different causes and different treatments available.

What is considered a recurrent UTI?

A recurrent UTI is if you get urinary tract infections twice in six months, or three times in a year.

What are the complications of a recurrent UTI?

Usually, a recurrent UTI can be treated easily and there are no complications. However, as with every condition some complications are possible. The infection can spread to your kidneys, causing a condition called pyelonephritis. If this is not treated it can damage the kidneys, affecting their function.

The infection can also spread to the blood, causing a condition called septicaemia.

Recurrent UTIs can also cause you to generally feel unwell, and eventually lead to sepsis. This is a very serious condition, in which other parts of the body start to show signs of infection as well.

If you are pregnant, recurrent UTIs also increase the risk of going into labour early.

What does it mean if a UTI comes back after antibiotic treatment?

There can be different reasons that the infection comes back. The most common cause that a bacterial infection would come back is that the bacteria are not sensitive to the antibiotic, or have developed a resistance to the antibiotic.

In these cases, we send a sample to the lab which will allow them to check which antibiotic is best.  

It could also be caused by the patient not completing their antibiotic course as instructed.

Another possible cause is that the diagnosis was wrong. Conditions such as cystitis or painful bladder syndrome are sometimes misdiagnosed as UTIs. The symptoms are very similar, so it is treated as a UTI with the appropriate antibiotics, but of course, the symptoms come back.

In some cases, UTI symptoms can be caused by something much more serious such as bladder cancer.

Are recurrent UTIs a sign of anything serious?

In most cases, there is no serious cause of recurrent UTIs. However, if it is not being cured by antibiotics we need to assess if it is a UTI or something serious.

If you see blood in the urine, it can be a sign of bladder cancer, although this is rare. Your GP should see these signs and do the relevant tests.

What is the most effective treatment for recurrent UTIs?

There is not one single cause of recurrent UTI, so there isn’t a single most effective treatment. If you are suffering from recurrent UTIs my advice is to speak to your GP, and they can assess what the best treatment will be for you.

For example, women who have gone through menopause can suffer from vaginal dryness which can lead to recurrent UTIs. Your doctor can offer you an oestrogen cream that can ease these symptoms and help prevent UTIs from returning.

Another possible cause of recurrent UTIs is a prolapsed bladder, which means that you can’t fully empty your bladder. In this case, the prolapse needs to be treated.

A scan of your kidneys can also be done, to ensure that there are no serious problems that could be predisposing the patient to recurrent UTIs.

If there are no other problems that could be causing the recurrent UTIs, your doctor should offer you general advice. This can include drinking plenty of water and wiping from front to back rather than back to front.

Sometimes the patient will be given a small dose of antibiotic for six months, and hopefully the UTI will not come back. Some people are prone to getting UTIs following sexual intercourse. If this is the case people can take an antibiotic following sexual intercourse.

Ms Sameena Muzaffar is a highly-renowned obstetrician-gynaecologist based in Winchester. If you would like to book a consultation with Ms Sameena Muzaffar you can do so right now via her Top Doctors profile.