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Recurrent Urinary Tract Infection (UTI)

Recurrent Urinary Tract Infection (UTI) - What it is

A urinary tract infection (UTI) is an infection in any part of your urinary system, which includes kidneys, bladder, ureters, and urethra.

Recurrent UTIs refer to:
  • More than 2 infections in last six months OR
  • More than 3 infections in one year 
It is more common among women, even among young, healthy women.

Why do recurrent UTIs occur?

There are many possible causes that might predispose an individual to developing recurrent UTIs. These include:

Behavioural risk factors:
  • Spermicide use during the past year
  • Having a new sex partner during the past year
  • Having a first urinary tract infection (UTI) at or before 15 years of age
  • Having a mother with a history of UTIs
Urological factors: 
  • Urinary incontinence 
  • Presence of a cystocele (a condition in which supportive tissues around the bladder and vaginal wall weaken and stretch, allowing the bladder and vaginal wall to fall into the vaginal canal.)
  • Post-voiding residual urine (urine left in your bladder after passing urine)
Medical and hormonal factors:
  • Atrophic vaginitis due to oestrogen deficiency
  • Diabetes mellitus 
  • Kidney, ureteric and bladder stones
  • Stroke
  • Spinal cord injury

Recurrent Urinary Tract Infection (UTI) - Symptoms

Recurrent Urinary Tract Infection (UTI) - How to prevent?

  • ​Adequate fluid intake (target of 2-3L daily)
  • Contraception modification. An alternate method of contraception that does not include a spermicide-containing product should be considere
  • Postcoital voiding
  • Perineal hygiene
  • Avoid douching and wearing occlusive underwear
  • Topical oestrogen for postmenopausal women. Topical oestrogen normalises the vaginal flora, thereby reducing risk of UTI. Side effects of vaginal oestrogen are usually mild, which include vaginal bleeding, discharge, and discomfort.
  • Lactobacillus probiotics may facilitate vaginal flora restoration, which helps preventing UTIs
  • Cranberry products has possible but limited benefits
  • Continuous or post-coital antibiotics are used when other measures have failed.

Recurrent Urinary Tract Infection (UTI) - Causes and Risk Factors

Recurrent Urinary Tract Infection (UTI) - Diagnosis

  • Urine sample to test for UTI-causing bacteria
  • In patients >40 years or have other risk factors, imaging such as US, CT/MRI or cystoscopy may be required for further evaluation


Recurrent Urinary Tract Infection (UTI) - Treatments

Recurrent Urinary Tract Infection (UTI) - Preparing for surgery

Recurrent Urinary Tract Infection (UTI) - Post-surgery care

Recurrent Urinary Tract Infection (UTI) - Other Information

The information provided is not intended as medical advice. Terms of use. Information provided by SingHealth

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