Urinary Tract Infection (UTI) and Chronic UTIs

Urinary tract infections (UTI) are one of the more common medical conditions in urology. Women tend to get more UTIs than men regardless of age. Women, unfortunately, who are prone to UTIs often have reoccurring infections, with 1 in 5 experiencing chronic UTIs.

A UTI can involve any part of the urinary tract including the kidneys, ureters, bladder or urethra. The following terms corresponds to the location of the infection such pyelonephritis (kidney), cystitis (bladder), urethritis/prostatitis (urethra/prostate).

• Dysuria (painful or difficult urination)
• Hematuria (blood in the urine)
• Frequency/urgency to urinate
• Loss of urinary control
• Back pain
• Fever
• Pelvic or abdominal pain
• Foul-odor urine

• A shortened urethra (female)
• Sexual activity
• Declining effects of estrogen on the vaginal mucosa
• Congenital anomalies causing urinary reflux from the bladder to the kidney
• Blockage of urine from the kidney to the bladder and/or from the bladder to the urethra leading to the retention of urine
• Presence of a foreign body such as a catheter or stent
• Constipation
• Immunosuppression caused by medication such as steroid or medical condition such as diabetes.
• Urinary incontinence

To evaluate a potential UTI, the following tests are typically done:

• History and physical examination
• Laboratory tests such as CBC, metabolic panel, urinalysis and culture
• Imaging such as ultrasound and CT scan
• Functional voiding studies such as uroflow and post-void residual studies or urodynamics studies
• Cystoscopy

A UTI is commonly treated with antibiotics.

For those with chronic UTIs – 3 or more a year – a more aggressive treatment plan may be need that includes these treatment options:

• Taking a low dose of an antibiotic over a longer period to help prevent repeat infections
• Taking a single dose of an antibiotic after sex, which is a common infection trigger
• Taking antibiotics for 1 or 2 days every time symptoms appear