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recurring urinary tract infection

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Urinary system

Alternative Names
chronic urinary tract infection, recurrent UTI, chronic UTI, relapsing urinary tract infection, relapsing UTI, chronic cystitis

Recurring urinary tract infection (UTI) involves repeated infections of the kidneys or bladder even after proper treatment.

What is going on in the body?
UTIs are usually caused by bacteria. In most cases, the bacteria enter the body through the skin around the genitals and anal area. The bacteria travel up toward the bladder or kidneys. If the bacteria are not killed by the person's immune system, an infection can occur.

What are the signs and symptoms of the infection?
A UTI may cause any of the following symptoms:
  • fever
  • the need to urinate frequently
  • painful urination
  • pain in the abdomen or on the sides of the back below the ribs
  • nausea and vomiting
  • incontinence, or involuntary loss of urine
  • a sensation of fullness in the lower abdomen
  • blood in the urine
What are the causes and risks of the infection?
Recurrent UTIs can occur for many reasons, including:
  • problems with the immune system
  • the use of a urinary catheter to empty the bladder
  • abnormalities in kidneys, ureters, bladder or urethra can cause repeated infections. The ureters are tubes that carry urine from the kidneys to the bladder. The urethra is a tube that carries urine from the bladder to the outside of the body.
  • damage to part of the urinary system
  • sexual intercourse, which seems to trigger UTI in some women
  • poor hygiene, such as wiping from back to front after a bowel movement or not changing the underwear often.
What can be done to prevent the infection?
Prevention of recurring urinary tract infections can involve several steps:
  • A woman who develops UTIs after sexual intercourse may take antibiotics, such as sulphamethoxazole/trimethoprim, before signs of infection occur.
  • A person who has a urinary catheter in the bladder needs to have the device changed or cleaned often.
  • Good hygiene is important for everyone, but especially for those who are bedridden and incontinent.
  • A person should drink 8 glasses of water every day.
  • A person should urinate when the urge is felt, rather than holding urine in the bladder for long periods of time.
How is the infection diagnosed?
A history of the symptoms is taken by a doctor. A urine sample may be sent to a laboratory for a urinalysis and a urine culture. Infected urine often contains bacteria and white blood cells, the infection-fighting cells of the body. Normal urine contains little or no bacteria or white blood cells.

What are the long-term effects of the infection?
Recurring UTIs can damage the urinary system. A UTI can spread to the blood, causing sepsis. That can cause severe illness and even death.

What are the risks to others?
UTIs are usually not contagious. However, infections of the urethra are generally spread through sexual contact.

What are the treatments for the infection?
A person who has an abnormality in the urinary system may be able to have surgery to correct the problem. Otherwise, antibiotics, such as sulphamethoxazole/trimethoprim or nitrofurantoin, are given to treat the UTI. A person may need to take these medications for a week or more in difficult cases of recurrent infection.

A person who has an artificial device, such as a urinary catheter, in the bladder should have the device changed or cleaned regularly.

What are the side effects of the treatments?
Antibiotics may cause allergic reactions and stomach upsets. Other side effects vary depending on the medication used.

What happens after treatment for the infection?
The person can usually go back to normal activities once the symptoms have gone away.

How is the infection monitored?
Often, a person with recurring UTIs is asked to give a urine sample after treatment is completed. A urinalysis and urine culture can be done to check that the bacteria are gone from the urinary tract.

Author: Adam Brochert, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Potential conflict of interest information for reviewers available on request

This website and article is not a substitute for independent professional advice. Nothing contained in this website is intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for your own health professional's advice.  All Health and any associated parties do not accept any liability for any injury, loss or damage incurred by use of or reliance on the information.


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