Recurrent UTI

Recurrent UTI is defined as the occurrence of three or more episodes of UTI in the preceding 12 months, or two episodes in the preceding six months. The causes of recurrent UTI are genetic or behavioural. Women who are non-secretors of blood group substances are at increased risk of recurrent UTI. A secretor is a person who secretes his or her blood type antigens into the body fluids and secretions like saliva.

The risk factors associated with recurrent UTI in sexually active premenopausal women include frequency of sexual intercourse, use of spermicides, the age of first UTI (the risk is greater if it is less than 15 years), and history of UTI in the mother, suggesting that genetic factors may be involved. The risk factors after the menopause include bladder prolapse, incontinence, and residual urine in the bladder after passing urine.

If there are recurrent UTIs, the doctor will refer the patient to a specialist, who will recommend the necessary measures for the identification and treatment of the underlying cause.

Prophylactic antibiotics may be prescribed. Other prophylactic measures like the vaginal application of lactobacilli, and consumption of cranberry juice, have been reported to have produced variable effects.

The doctor may prescribe "bladder toilet", i.e. drinking at least two to three litres of fluid daily and always passing urine before going to bed and after sexual intercourse.

Those who have urinary tract conditions that require surgical intervention will be advised accordingly by the urologist.

Dr Milton Lum is member of the board of Medical Defence Malaysia. This article is not intended to replace, dictate or define evaluation by a qualified doctor. The views expressed do not represent that of any organisation the writer is associated with.