Recurrent Urinary Tract Infections

Reviewed by Nirit Rosenblum, M.D.

The physicians of NYU Urology Associates are highly experienced in the treatment of recurrent urinary tract infections. We begin by evaluating the underlying causative factors of your infections and perform a comprehensive evaluation of the urinary tract. Once unusual conditions such as a kidney stone or anatomical abnormality have been ruled out, we develop a program of prevention and/or management tailored to your situation.


More information on recurrent urinary tract infections

Definition

A urinary tract infection, or UTI, is an infection in the lining of the urinary tract. The urinary tract includes the bladder, kidneys, ureter (the upper urinary tract, connecting the kidney to the bladder) or the urethra (the lower urinary tract, which empties the bladder to the outside).

Usually, symptoms of a urinary tract infection disappear within 24–48 hours after treatment begins. However, if the condition occurs more than twice in 6 months, it is considered recurrent.

Causes

Urinary tract infections result from the invasion of the urinary tract by bacteria, which can enter through the urethral opening. The growth of bacteria can lead to inflammation as the body tries to fight the bacterial infection.

A recurrent urinary tract infection can result from invasion by new bacteria from outside the body, or by bacteria from a previous infection that have persisted within the urinary tract.

Risk factors

In adults, recurrent urinary tract infections are more common in women than in men.

Other risk factors may include:

  • Previous urinary tract infection
  • Residency in a nursing home or hospitalization
  • Catheterization
  • Immobility
  • Diabetes
  • Kidney stones
  • Bowel incontinence
  • Previous urologic surgery
  • Congenital urinary tract anomalies
  • Sexual activity
  • Prostatic obstruction (in older men)

Symptoms

  • Increased frequency or urgency of urination
  • Pain or burning during urination
  • Cloudy, foul-smelling urine
  • Lower abdominal or pelvic pain
  • Increased need to urinate at night
  • Blood in the urine
  • Fever and chills
  • Flank pain

Diagnosis

The doctor will ask you about your medical history and perform a physical exam. You may also undergo one or more of the following tests:

  • Urine collection
  • Urethral catheterization
  • Analysis of the urine for bacteria or white blood cells
  • X-ray study of the urinary tract
  • In children, special imaging studies may be necessary to determine if they have an anatomical abnormality that predisposes them to infections.

Treatment

Antibiotics are commonly used to treat recurrent urinary tract infections. These may include nitrofurantoin, cephalosporins, ampicillin, amoxicillin, aminoglycosides, aztreonam, fluoroquinolones, trimethoprim-sulfamethoxazole and vancomycin.

The duration of antibiotic treatment may vary, but uncomplicated infections can often be treated within 3 days. Complicated or unresolved infections may require longer-term therapy (10 days or more).

If an anatomical abnormality is present, surgery may needed to correct the problem.

Prevention

  • Drink plenty of fluids
  • Keep the genital area clean
  • Wear cotton undergarments
  • Wipe from front to back after a bowel movement or urination
  • Drink cranberry juice (except if you have a history of kidney stones)

Make an appointment with an NYU urologist

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.