Urinary Tract Infections affect 150 million people worldwide. We can define Recurrent UTI as at least two episodes of symptomatic infection with pus cells in urine or positive bacterial culture, in the past 6 months or three infections in the past 12 months.
What are the Symptoms of UTI ?
Common Symptoms Include:
- Dysuria or Burning / Pain in passing Urine
- Frequency or need to visit washroom multiple times
- Urgency or the need to suddenly rush to the washroom
- Pain in the Lower Abdomen
- Blood in Urine
- Fever with Chills
- Pain around the passage of Urine
What are the causes of Recurrent UTI ?
Risk factors for recurrent UTI include
- Diabetes,
- Functional disability,
- Recent sexual intercourse,
- History of urogynecological surgery,
- incomplete bladder emptying (elevated post-void residual),
- Blockage in the Urethra
- Accidental bowel contamination
- Kidney Stones
- Urethral Abscess or Diverticula
- Tuberculosis
- Urinary incontinence.
What are the tests we do to find the cause of recurrence ?
- Uroflowmetry: Helps to rule out blockage in the bladder which may cause retention of Urine
- Ultrasound KUB region: An ultrasound helps to ensure that there are no stones and urine is being completely cleared from the bladder
- Cystoscopy: Sometimes it is needed to scan the urinary passage and the urinary bladder with an endoscope. This procedure is called Cystoscopy
- CT Scan
- Urodynamics Study
How is Recurrent UTI Managed by our Experts
First step to manage recurrent UTI is to ensure that it actually is a UTI and not any other disease such as Pelvic Inflammatory Disease, Genito-urinary Tuberculosis, Interstitial Cystitis/ Bladder Pain Syndrome, Tumors etc. This can be done by making sure that all the UTIs are well documented and the culture shows presence of organisms in the right quantity.
Second step is to see wether this UTI is due to persistence of the organism or reintroduction of an organism. Presence of different micro-organisms in different culture reports suggests reintroduction.
Third step is to find the cause of the infections and work at removing the risk factors, improving bladder function and boosting local immunity.
How can recurrent UTI be managed ?
Here are some strategies that you can choose to manage recurrent UTI once the diagnosis has been confirmed by our experts and the risk factors have been identified.
| Treatment Strategy | Remarks |
|---|---|
| Cranberry Juice | Cranberry juice is useful (not curative in itself) although all research does not support it. 300 ml is the optimal daily dose |
| Avoid Spermicides such as coated condoms, diaphragms and cervical caps | active ingredient in spermicides (nonoxynol-9) is toxic to lactobacilli (normal protective bacteria) but not to E. coli |
| Douche and pee after intercourse | Post coital infection is a very common cause of recurrent UTI. After sex both partners should wash genitals with water and pass urine before sleeping off |
| Post Coital Antibiotic | If Sex is the trigger for your UTI then you must take a pill to kill the bacteria |
| D Mannose | Some scientific evidence suggests role of D Mannose in prevention of UTI |
| Probiotics | Research has indicated some benefit of probiotics |
| Estrogens | Post menopausal women with atrophy are greatly benefitted by Estrogen supplementation locally |
| Self Start Therapy | Many times our experts may as your to reflexly get a Urine CS test and self start a prescribed therapy to manage recurrent UTI |
| Chronic Suppressive Antibiotics | We may give you a few months of low dose antibiotics to kill the bacterial colonies |
| Intra-vesical Glycosaminoglycans | These chemicals form a protective layer and repair the bladder lining when instilled into the bladder |
Future treatments available with Urocentre for Recurrent UTI
In the future we are looking at introducing Vaccines, Immunostimulants and even competitive inoclulation of less virulent organisms into the bladder to prevent recurrent UTIs.
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