Recurring UTIs: Frequent and Chronic

What Causes Recurrent UTIs?

Bacteria can enter the urinary tract from the outside to cause a UTI to come back, or a recurrent infection can be caused by bacteria that remain in the urinary tract after a previous infection. Symptoms of recurrent UTIs in men and women include the frequent urge to urinate, burning pain or pressure, cloudy or discolored urine, bloody urine, and chills and fever. (1) Children with UTIs are more likely to have fever without the other symptoms. (1) Common conditions that can lead to recurrent UTIs include: (4,5)

• Being in a nursing home or hospital
• Diabetes
• Kidney or bladder stones
• Having a catheter
• Previous urinary tract surgery
• Sexual activity
• Certain types of birth control, including use of diaphragm or spermicide
• Menopause
• Having an infected or enlarged prostate
• Being born with an abnormality of the urinary tract

Why Does My UTI Keep Coming Back?

Chronic or recurring UTIs may keep coming back due to one of the risk factors listed above. Use of spermicides for birth control, for instance, may kill off beneficial bacteria in and around the vagina, making it easier for harmful bacteria to enter the urinary tract. (4)

In some cases, what seem like recurrent UTIs may actually be another condition, such as kidney stones or interstitial cystitis, a painful bladder condition with no infection. If you think you’re getting recurrent UTIs, see your provider, who can help rule out another condition, notes the ACOG. (4)

How Many Is Too Many UTIs?

Three or more UTIs in one year indicates a recurrent infection, according to the ACOG. (4)

UTIs, including recurrent ones, are treated with antibiotics, and you should start to feel better within a few days. But it’s important to complete your antibiotic course exactly as prescribed — even if you’re feeling better — as that can help reduce the chances of recurrence. (4)

Your doctor may also ask you about factors that increase the risk of a recurrent UTI, including: (4)

• Frequent sex
• A new sexual partner
• Diaphragm or spermicide use
• Young age at first UTI

How Are Chronic UTIs Treated?

If you have recurrent or chronic UTIs, your doctor may send you to a urologist, who specializes in diseases of the urinary system. According to the National Institute of Diabetes and Digestive and Kidney Diseases, some of the ways that recurrent UTIs are evaluated and treated include: (6,7)

• Testing The doctor will want to take a urine sample to test for bacteria and white blood cells. It may be necessary to do special X-ray studies to see if there is an obstruction or stones in the urinary tract. A urologist may look into your bladder by passing a special scope through the opening into your bladder. This exam is called cystoscopy.
• Antibiotics for Treatment Normally, UTIs respond very well to antibiotics, and you may only need to take medication for a prescribed course of just a few days. For recurrent UTIs, antibiotics may be needed for 10 days or more.
• Surgery In some cases of prostate disease, stones, or other obstruction of the urinary system, surgery may be done to restore normal flow of urine and help clear up infections.
• Antibiotics for Prevention Some strategies to prevent recurrent UTIs with antibiotics include taking low-dose antibiotics for six months or taking antibiotics after sexual intercourse.

While urinary tract infections, especially recurrent UTIs, can be a serious health problem that warrants a trip to your healthcare provider, recurrent UTIs are common, and there are many effective treatments available. Some simple things you can do to help prevent UTIs include drinking lots of fluids, keeping the genital area clean, wearing cotton underwear, and wiping from front to back after a bowel movement or urination. (7)

Can Recurrent UTIs Be a Sign of Cancer?

Both UTIs and bladder cancer can cause similar symptoms, such as a frequent need to urinate and even blood in the urine. (8)

According to the American Cancer Society, urinary tract infections, kidney and bladder stones, and other causes of chronic bladder irritation have been linked to bladder cancer. (9) However, it’s not clear whether recurrent urinary or bladder infections can actually cause bladder cancer or whether they constitute a true risk factor for bladder cancer.

The biggest known risk factor for bladder cancer is smoking. (8) The risk of bladder cancer also increases with age. Most people who get bladder cancer are over the age of 55. (9)

If you think you may have chronic or recurrent UTIs, it’s best to get checked out by your doctor. Your provider can rule out other health issues, including bladder cancer, and get you the treatment you need to get rid of chronic UTIs.