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Chronic Urinary Tract Infections (UTIs)

This relates to:

Men
Women

A chronic urinary tract infection (UTI) means repeated or ongoing infections of the urinary system (bladder, kidneys, or urethra)

Chronic Urinary Tract Infections (UTIs)

What are they?

A chronic urinary tract infection (UTI) means repeated or ongoing infections of the urinary system (bladder, kidneys, or urethra). UTIs are common, especially in women, but when they recur frequently they can be frustrating and significantly impact quality of life.

Key Symptoms:

  • Burning or pain when passing urine
  • Frequent or urgent need to urinate
  • Passing small amounts of urine often
  • Blood in the urine (haematuria)
  • Discomfort or pressure in the lower abdomen
  • In severe cases, fever, chills, or back pain (possible kidney involvement)

When it becomes “chronic”:

  • Recurrent UTIs: Two or more infections within 6 months, or three or more within a year
  • Persistent infection: When bacteria remain in the urinary tract despite treatment

Causes & Risk Factors:

  • Shorter urethra in women (easier for bacteria to reach the bladder)
  • Sexual activity
  • Menopause (lower oestrogen → changes in vaginal and bladder lining)
  • Urinary tract abnormalities (e.g. kidney stones, strictures)
  • Enlarged prostate in men
  • Catheter use
  • Certain medical conditions (e.g. diabetes, immune suppression)

Diagnosis:

  • Medical history and symptom pattern
  • Urine tests and cultures (to identify bacteria and guide treatment)
  • Imaging (ultrasound, CT, or cystoscopy) if recurrent infections raise concern for underlying structural issues

Treatment Options:

  • Acute treatment: Antibiotics guided by culture results
  • Prevention strategies:
    • Staying well hydrated
    • Regular and complete bladder emptying
    • Cranberry products or D-mannose (some evidence of benefit)
    • Vaginal oestrogen (in postmenopausal women)
    • Low-dose preventive antibiotics in select cases
  • Addressing underlying causes: Removing stones, treating prostate enlargement, or managing catheter use

Why seek help?

Chronic UTIs are more than just inconvenient—they can lead to kidney damage, resistant infections, and reduced quality of life. With proper assessment and tailored treatment, most people can achieve significant improvement and prevent recurrences.