When UTIs keep coming back, it’s time to talk to your doctor about
treatment options.
What is a chronic UTI?
A UTI (urinary tract infection) is an infection of the urinary tract. It’s
a common health problem, particularly for women. A UTI that doesn’t
respond to treatment, or keeps reoccurring, is considered a chronic UTI.
A UTI can affect any part of the urinary system, including your kidneys,
ureters, bladder, and urethra. While most UTIs are minor and can be cleared
up easily, women who experience chronic UTIs are at higher risk of complications,
including kidney disease, sepsis, septicemia, and, if pregnant, premature
delivery of babies.
What causes a chronic UTI?
A UTI happens when germs (most often bacteria from the digestive tract)
get into the opening of the urethra, where they start to multiply and
spread. This might happen during sex. It can also occur due to poor genital
hygiene, improper wiping technique or urinary incontinence. A UTI can
also be caused by certain types of kidney stones or abnormal connections
between the intestines and bladders.
What are the symptoms of a chronic UTI?
Symptoms of a UTI or chronic UTI include:
Frequent urination
Bloody or dark urine
A burning sensation while urinating
Pain in your kidneys (your lower back area, below your ribs)
Pain in your bladder region
Pelvic pressure
If a UTI has spread to your kidneys, symptoms may also include:
Nausea and vomiting
Chills
Fever
Fatigue
Confusion and mental disorientation
Medical evaluation for chronic UTIs may include X-rays such as renal and
bladder ultrasounds, CT scans and/or cystoscopy.
Reducing risk of chronic UTI
Be sure to follow these strategies to reduce your risk of UTI, particularly
if you are susceptible to reoccurring infections:
Drink plenty of water throughout the day
Urinate when you feel the need—don’t wait!
Always wipe from front to back to keep bacteria from going in the vagina
or urethra
Take showers instead of baths
Clean the genital area before and after sex
Urinate shortly after sex
Avoid feminine hygiene sprays or scented douches
Wear cotton underwear and loose-fitting clothes to help keep the area around
the urethra dry (tight, restrictive clothes can trap moisture and help
bacteria grow)
What are treatment options for chronic UTI?
The most common treatment for UTIs is antibiotics. But some UTIs last longer,
or keep coming back, which can be frustrating and require special treatment.
Treating chronic UTIs may involve a combination of medicine and lifestyle
changes. Here are a few treatment options for chronic UTIs:
Antibiotics: Chronic UTIs often require a longer course of antibiotics, usually for
several weeks or months. The type of antibiotic depends on the type of
bacteria causing the UTI, as well as how the bacteria respond. It’s
important to complete the entire course of antibiotics, even if symptoms
improve. That way, the infection fully clears.
Prophylactic antibiotics: Some women with chronic UTIs may take a low-dose antibiotic daily for
several months or longer. Taking this type of antibiotic can help prevent
infections from coming back.
Bladder instillation therapy: This therapy involves a provider adding solution directly into the bladder.
It helps reduce inflammation and prevent UTIs from coming back.
Urinary tract analgesics: Over-the-counter pain relief, such as phenazopyridine, may help with
discomfort and the burning feeling from the UTI.
Lifestyle changes: Some routine changes may help reduce your risk of chronic UTIs:
Wipe from front to back after using the toilet.
Drink plenty of fluids, especially water and cranberry juice (or take cranberry
extract pills).
Urinate often and completely to flush out bacteria.
Avoid douches and perfumed products that irritate the pelvic area.
Urinate before and after sexual activity.
Wear breathable cotton underwear.
Avoid tight-fitting clothing.
Your provider may encourage you to monitor your urinary system at home.
Regular at-home urine tests can help you check for infection. It’s
important to work closely with your provider to find the best treatment
plan for your specific case of chronic UTIs.
