Urologist explains what causes recurrent UTIs and how to prevent them

Urinary tract infections are among the most common bacterial infections in women, but for some, a single course of antibiotics is not the end of it. When infections return twice within six months or three times within a year, the condition is classified as recurrent urinary tract infection, or recurrent UTI.

Dr Sarika Pandya, Senior Consultant in the Department of Female Urology and Reconstructive Urology at Asian Institute of Nephrology and Urology, Hyderabad, spoke to HT Lifestyle about why recurrent UTIs occur and what women can do about them.

Why women are more vulnerable

Women are anatomically more susceptible to UTIs because their shorter urethra allows bacteria to travel to the bladder more easily. Several factors can increase that risk further.

"Several factors increase the risk of recurrent infections, including menopause, diabetes, pregnancy, inadequate fluid intake, constipation, urinary stones, incomplete bladder emptying, and sexual activity," Dr Pandya said. "Certain pelvic floor disorders and urinary incontinence may also contribute to repeated infections," she added.

Recognising the symptoms

The symptoms of recurrent UTI mirror those of a standard urinary infection and typically include a burning sensation while passing urine, increased frequency and urgency, lower abdominal discomfort, cloudy urine, and blood in the urine.

Dr Pandya cautioned that some symptoms warrant urgent attention. "Fever and flank pain may indicate that the infection has spread to the kidneys and require immediate medical attention," she said.

The danger of self-medication

Women who experience repeated infections are often tempted to manage them on their own, but Dr Pandya warned against that approach. "Repeated self-medication or frequent use of antibiotics without proper evaluation can lead to antibiotic resistance, making infections more difficult to treat," she said.

Proper diagnosis involves urine examination and a urine culture to identify the responsible bacteria and determine the most effective antibiotic. In some patients, additional investigations such as ultrasound, uroflowmetry, cystoscopy, or specialised bladder function studies may also be needed to uncover any underlying causes.

Prevention through lifestyle

Many recurrent UTIs can be avoided through straightforward daily habits. Dr Pandya highlighted drinking adequate water, avoiding prolonged holding of urine, maintaining good bowel habits, practising proper genital hygiene, and controlling diabetes as key preventive measures.

For some women, medical intervention may also be necessary. "Postmenopausal women may benefit from vaginal oestrogen therapy under medical supervision," Dr Pandya noted. "Some patients may require preventive antibiotics or newer non-antibiotic approaches depending on their individual risk factors," she added.

Impact on quality of life

The burden of recurrent UTIs extends well beyond physical discomfort. "Recurrent UTIs can significantly affect a woman's quality of life, leading to discomfort, anxiety, sleep disturbances, and repeated hospital visits. However, with proper evaluation and personalised treatment, most women can achieve long-term relief and prevent future infections," Dr Pandya said.

She also urged women not to normalise the condition or suffer in silence. "Women should remember that recurrent urinary infections are not a normal part of ageing and should not be suffered in silence. Early consultation with a urologist can help identify the underlying cause and provide effective treatment, allowing women to lead healthy and active lives," she said.

Note: This article is for informational purposes only and is not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.