What is a Urinary Tract Infection (UTI)?

Urinary Tract Infection (UTI) is the name given to an infection in any part of the urinary system, usually by bacteria. Bacteria enter the urinary system through the urethra, or more rarely, through the bloodstream.

I keep getting repeated infections. What is the definition of recurrent UTIs?

If you have had two infections within six months, or three within the space of a year, this is defined as recurrent UTIs. This is a very frustrating experience for you. It may be that your first infection was not fully treated or it may be that unfortunately, you are more susceptible to these infections. You may have been taking antibiotics for several months and it may not be clear what is effective and what is not. In these circumstances, seeing a bladder specialist is advised in order to resolve this recurring problem. In addition to taking samples of urine (which is likely to have been done by your GP), we can carry out further investigations to assess whether there is an underlying cause which needs to be addressed.

Symptoms of urinary tract infections

The symptoms of UTI can vary, depending on whether the infection affects the lower (bladder and urethra) or upper (kidneys and ureters) parts of the urinary tract.

The symptoms of lower urinary tract infection are:

• Burning sensation on passing urine
• Need to pass urine more frequently than normal
• Need to hurry to the toilet to pass urine
• Urine can be cloudy with an offensive odour

People with upper urinary tract infection are likely to experience the symptoms above, plus:

• Feeling unwell
• Having a high temperature and chills
• Loin (kidney) pain
• Patient is likely to be ill and could require hospital admission

Additional investigations we use to assess repeated UTIs

• Ultrasound scan of the bladder and/or kidneys to assess whether there are stones or whether you have a structural abnormality which means you are not emptying your bladder fully when you go to the toilet
• Cystourethroscopy: this is an examination of the inside of the bladder using a flexible telescope inserted into the bladder via the urethra

Treatment of recurrent urinary tract infections

Single UTIs are normally treated effectively with a course of antibiotics. However, if you are suffering from recurrent UTIs, successful treatment requires using several strategies to meet your needs. These may include:

• Medical therapy: we need to tailor the antibiotics to your needs. This may involve assessing your sample test results and using a different antibiotic and a small number of women benefit from taking a continuous low dose of antibiotics.
• Post-menopausal women may benefit from short courses of vaginal oestrogens to help improve the protective lining of the vagina.
• If you have had recurrent UTIs, you have probably tried some lifestyle changes, such as drinking more water, cranberry juice and Lactobacilli yoghurts. However, our consultant urologist has extensive, specialist experience and can advise you on the latest research and advice and ensure that your medical therapy and lifestyle changes are combined optimally to achieve an effective solution.
• It is very rare for surgery to be required, but if investigations show your recurrent UTIs are due to an abnormality in your bladder or vaginal tract, we are able to undertake surgery necessary to address the underlying cause of repeated infections.