Chronic Cystitis - Recurring Urinary Tract Infection
Overview, Causes, & Risk Factors
Recurring urinary tract infection (UTI) involves repeated infections of the kidneys or bladder even after proper treatment.
What is going on in the body?
UTIs are usually caused by bacteria. In most cases, the bacteria enter the body through the skin around the genitals and anal area. The bacteria travel up toward the bladder or kidneys. If the bacteria are not killed by the person's immune system, an infection can occur.
What are the causes and risks of the infection?
Recurrent UTIs can occur for many reasons, including:
problems with the immune system
the use of a urinary catheter to empty the bladder
abnormalities in kidneys, ureters, bladder or urethra can cause repeated infections. The ureters are tubes that carry urine from the kidneys to the bladder. The urethra is a tube that carries urine from the bladder to the outside of the body.
damage to part of the urinary system
sexual intercourse, which seems to trigger UTI in some women
poor hygiene, such as wiping from back to front after a bowel movement or not changing the underwear often.
Symptoms & Signs
What are the signs and symptoms of the infection?
A UTI may cause any of the following symptoms:
the need to urinate frequently
pain in the abdomen or on the sides of the back below the ribs
nausea and vomiting
incontinence, or involuntary loss of urine
a sensation of fullness in the lower abdomen
blood in the urine
Diagnosis & Tests
How is the infection diagnosed?
A history of the symptoms is taken by a healthcare provider. A urine sample may be sent to a lab for a urinalysis and a urine culture. Infected urine often contains bacteria and white blood cells, the infection-fighting cells of the body. Normal urine contains little or no bacteria or white blood cells.
Prevention & Expectations
What can be done to prevent the infection?
Prevention of recurring urinary tract infections can involve several steps:
A woman who develops UTIs after sexual intercourse may take antibiotics, such as sulfamethoxazole/trimethoprim, before signs of infection occur.
A person who has a urinary catheter in the bladder needs to have the device changed or cleaned often.
Good hygiene is important for everyone, but especially for those who are bedridden and incontinent.
A person should drink 8 glasses of water every day.
A person should urinate when the urge is felt, rather than holding urine in the bladder for long periods of time.
What are the long-term effects of the infection?
Recurring UTIs can damage the urinary system. A UTI can spread to the blood, causing sepsis. That can cause severe illness and even death.
What are the risks to others?
UTIs are usually not contagious. However, infections of the urethra are generally spread through sexual contact.
Treatment & Monitoring
What are the treatments for the infection?
A person who has an abnormality in the urinary system may be able to have surgery to correct the problem. Otherwise, antibiotics, such as sulfamethoxazole/trimethoprim or nitrofurantoin, are given to treat the UTI. A person may need to take these medications for a week or more in difficult cases of recurrent infection.
A person who has an artificial device, such as a urinary catheter, in the bladder should have the device changed or cleaned regularly.
What are the side effects of the treatments?
Antibiotics may cause allergic reactions and stomach upsets. Other side effects vary depending on the medication used.
What happens after treatment for the infection?
The person can usually go back to normal activities once the symptoms have gone away.
How is the infection monitored?
Often, a person with recurring UTIs is asked to give a urine sample after treatment is completed. A urinalysis and urine culture can be done to check that the bacteria are gone from the urinary tract.
Author:Adam Brochert, MD
Editor:Coltrera, Francesca, BA
Reviewer:Gail Hendrickson, RN, BS
Principles and Practice of Infectious Diseases, 1995, Mandell et al