Frequent UTIs: Diagnosis and Treatment

For many women nationwide, urinary tract infections (UTIs) have become an uncomfortable constant in their day-to-day lives. Even more alarming, UTIs can often recur, particularly for those who have experienced them before. Research from the National Library of Medicine indicates that between 50% and 60% of women will experience a UTI at some point in their lifetime, with approximately 25% of women experiencing recurrent UTIs. Given the widespread impact of this issue, it’s no wonder that misinformation and misdiagnoses are incredibly pervasive. Fortunately, our urologists in Newport News and Williamsburg, VA can provide a proper diagnosis and effective treatment for those who suffer from recurrent UTIs.

What are Recurrent UTIs?

A UTI is an infection that occurs in the urinary system. Most UTIs are caused by bacteria, such as E. coli, which can enter the urethra and travel to the bladder, ureters, and even your kidneys in some instances. The American Urological Association (AUA) defines recurrent UTIs as having two culture-proven (confirmed by a laboratory) UTIs within a six month period or three within a year. While UTIs are most common among women, men are also susceptible to these infections.

What are the Symptoms of Recurrent UTIs?

Symptoms of a UTIs and recurrent UTIs are the same, and they include:

• Urinary incontinence
• Frequent urination
• Urge incontinence
• Dysuria (pain whilst peeing)
• Hematuria (blood in urine)
• Cloudy, foul-smelling pee
• Suprapubic pressure (pressure in the lower part of the pelvis)
• Pain in the lower back, flank, abdomen, or pelvis

Why Causes UTIs to Recur?

Several factors can lead to the recurrence of UTIs. Increasing antibiotic resistance in our population over the past two decades may have diminished the effectiveness of some treatments. Sexual activity or hygiene may also play a role. Vaginal atrophy, often associated with menopause, can also contribute. Diabetic patients can also have a higher risk of developing UTIs, especially if they take medications like Jardiance, which increases the sugars in urine. Those who don’t completely empty their bladder when urinating or try to hold in their pee too long may also experience UTI recurrence.

Experiencing a UTI can heighten your risk of subsequent infections. Bacteria that caused the initial infection causes inflammation of the bladder allowing bacteria to linger or colonize the bladder lining, making it difficult to eradicate.

Regrettably, in some cases, the reasons for recurring UTIs remain unclear. Some people are simply more susceptible to UTIs than others. While frustrating, effective treatment options can help address challenges posed by recurrent UTIs.

How are Recurrent UTIs Diagnosed?

When you consult a healthcare provider due to concerns about a UTI, they will likely initiate the diagnostic process. This typically involves gathering a comprehensive medical history, discussing your symptoms, and performing a urine culture to confirm the diagnosis. Depending on the situation, your provider may also perform a physical exam or other testing if deemed necessary. Those with a history of recurrent UTIs may also receive an ultrasound to check the kidneys and upper urinary tract, or a cystoscopy to examine the bladder. Since many other conditions like overactive bladder or interstitial cystitis can mimic the symptoms of a UTI, it’s important to verify that what your symptoms are indeed a urinary tract infection. The rise in telemedicine services and home remedies has also led to an increase in UTI misdiagnosis. An incorrect diagnosis can result in ineffective treatment and potential complications related to other health conditions.

How are Recurrent UTIs Treated?

Once a diagnosis is confirmed through urine culture testing, treatment can begin. Focusing on prevention, the management of recurrent UTIs typically involves over-the-counter supplements like Cranberry, D-Mannose, prebiotics/probiotics and vitamin C. Additionally, increasing your water intake daily is beneficial. Postmenopausal women may consider using vaginal estrogen cream as well. If you follow these preventative measures and still experience recurrent UTIs, your provider may recommend a prophylactic antibiotic, which is a low-dose antibiotic taken daily (or within 2 hours of intercourse if caused by sex), or an antibacterial such as methenamine.

“Treatment is a process, but it’s something that we continuously work towards and work with. You don’t have to live with recurrent UTIs,” said board certified family nurse practitioner, Lakisha Swindell-Glenn, MSN, FNP-BC of TPMG Urology in Newport News.

Preventing UTI Recurrence at Home

There are a couple of ways to reduce your risk of contracting a UTI at home. If you experience frequent UTIs, try making these changes to reduce your risk of recurrence.

• Hydration Boosting your water intake can lower your risk of UTI by up to 50%. Aim to drink at least one and a half to two liters of water daily.

• Hygiene Poor hygiene practices can increase the likelihood of bacteria reaching the urethra. When using the restroom, always wipe from front to back to reduce E. coli exposure. Properly washing and drying front to back daily is important. Additionally, regularly changing incontinence pads is important. Avoid using topical products around the vaginal area that can trap moisture, unless advised by a healthcare provider.

• Urination Frequent urination can help flush the bacteria out of your urethra and prevent infection. Avoid holding your urine for extended periods of time and ensure you completely empty your bladder when using the restroom.

• Clothing Wearing tight-fitting clothing or dirty clothing for too long can also promote bacterial growth. Try to wear loose-fitting, clean garments.

When to See a Doctor for Recurrent UTIs

Although some mild urinary tract infections may resolve on their own, the majority of UTIs require treatment for recovery. Failing to address a UTI may lead to your condition worsening. Those who are elderly or have weakened immune systems risk developing sepsis, a serious condition in which an infection triggers inflammation and damage throughout the body, which could lead to organ failure and even death.

All in all, it’s a good idea to contact a trusted healthcare provider if you notice symptoms of a UTI sooner, rather than later. Beyond the potential dangers associated with an unaddressed UTI, the condition can also be uncomfortable for those suffering. Talking with a qualified provider will get you on the right track toward feeling and functioning your best.

Treatment for Recurrent UTIs in Newport News & Williamsburg, VA

If you are experiencing UTI symptoms, or you have been diagnosed with two or more urinary tract infections within a six-month period or three urinary tract infections within a year, TPMG Urology can help you get relief. Our highly trained, board-certified Urologists provide recurrent UTI diagnosis and treatment at two convenient locations in Hampton Roads. Call (757) 873-2562 to schedule an appointment with a urologist in Newport News, or call (757) 345-6223 to see a urologist in Williamsburg, VA.