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Chronic Urinary Tract Infections (UTIs): Causes, Symptoms, and Treatment

Chronic Urinary Tract Infections (UTIs), also known as recurrent UTIs, are infections of the urinary system that either persist despite treatment or return frequently after treatment.

What Is a Chronic UTI?

A chronic UTI is defined as having at least three episodes of UTI in one year or at least two episodes within six months. UTIs can affect various parts of the urinary tract, including the bladder, kidneys, ureters, and urethra. Chronic UTIs can be frustrating, as they may recur despite adequate treatment. These infections typically occur when bacteria from the rectum or genital area migrate to the urinary tract, causing infection.

What Causes Chronic UTIs?

The primary cause of chronic UTIs is bacterial infection, often due to Escherichia coli (E. coli), which naturally lives in the intestines. In some cases, a UTI may not completely resolve after treatment, leading to relapse. Other times, new bacterial infections may occur, known as reinfection.

Certain factors can increase the risk of recurrent UTIs, such as:

  • Being female (due to the shorter urethra)
  • Sexual intercourse or a new sexual partner
  • Use of spermicides or birth control pills
  • Inadequate hydration
  • Delaying urination or improper hygiene practices
  • Wearing tight-fitting underwear
  • Conditions like diabetes, kidney stones, or structural abnormalities in the urinary tract

What Are the Symptoms of Chronic UTIs?

  • Pain or burning sensation during urination
  • Frequent and urgent need to urinate
  • Cloudy, foul-smelling, or bloody urine
  • Pain in the lower abdomen or lower back

In severe cases (such as when the kidneys are involved), fever, chills, nausea, and vomiting may also occur

How Are Chronic UTIs Diagnosed?

To diagnose chronic UTI, doctors typically assess the patient’s medical history and symptoms, followed by a urine test to check for the presence of bacteria. Additional tests, such as imaging studies (ultrasound or CT scan), may be recommended to detect structural issues in the urinary tract that could be contributing to recurring infections.

How Are Chronic UTIs Treated?

The mainstay treatment for chronic UTIs is antibiotics. However, for recurrent cases, a long-term, low-dose antibiotic course may be prescribed to prevent future infections. In cases where UTIs are linked to lifestyle factors or other medical conditions, doctors may also recommend:

  • Increasing water intake to flush out bacteria
  • Practicing proper hygiene (e.g., wiping front to back)
  • Avoiding spermicides and using alternative birth control methods

In some cases, if structural issues or complications like kidney stones are present, surgical intervention may be necessary.

Can Chronic UTIs Be Prevented?

Preventive measures for chronic UTIs include:

  • Drinking plenty of water
  • Urinating after sexual activity
  • Avoiding tight clothing and synthetic underwear
  • Practicing good hygiene, including wiping front to back
  • Avoiding holding urine for long periods

Chronic UTIs can be challenging to manage, but with proper treatment and preventive strategies, many people find relief. If you experience frequent UTIs, consult your doctor for an individualized treatment plan. Early intervention can help reduce the frequency of infections and prevent complications.