Feature Article

Recurrent urinary tract infections. Management in women

PAYAM NIKPOOR, PETER L. DWYER

Figures

© Tharakorn/istockphoto.com
© Tharakorn/istockphoto.com

Abstract

Recurrent lower urinary tract infection (UTI) is a common problem seen in general practice affecting more women than men. Fifty per cent of women will experience at least one UTI during their lifetime and 20% will have recurrent UTIs.

Key Points

  • Lower urinary tract infections (UTIs) are among the most common patient presentations to general practice.
  • For various anatomical and physiological reasons, UTIs are more common in women, with 50% experiencing at least one UTI in their lifetime.
  • Evidence of two or more UTIs in six months, or three or more UTIs in one year is defined as recurrent UTI (rUTI).
  • Urine microscopy, culture and sensitivity is the gold standard diagnostic investigation for UTI and rUTI.
  • Women with rUTI need further investigations to identify underlying causes.
  • Antibiotics are at the core of UTI treatment, but for rUTIs they may be considered as a prophylactic option.
  • Nonantiobiotic options include methenamine hippurate and topical oestrogens.
  • General advice to women with rUTI is directed at lifestyle modification, personal hygiene, safe sex practice and sexual behaviour modification.

Figures

© Tharakorn/istockphoto.com
© Tharakorn/istockphoto.com