Recurrent Urinary Tract Infection: What You Need to Know

Traditionally, urinary tract infections refer to 2 episodes of urinary tract infection within 6 months or 3 attacks within a year, although any second episode of urinary tract infection can be considered as a recurrence.

E. coli has been shown to be responsible for 70-95% of all urinary tract infections, Staphylococcus saprophyticus and Proteus mirabilis are in the next category of these infections.

Occurrence of urinary tract infections

In women, the chance of getting a urinary tract infection during their lifetime is 1 out of every 2 people, and this rate is directly related to increasing age. Urinary tract infection is seen even in completely healthy people and middle-aged men, although it is more common in older men.

It seems that most of the cases of recurrence of urinary tract infections are with the same microbe, studies have shown that between 30 and 45% of non-pregnant women with a urinary tract infection will have a recurrence of the same infection.

In children before the age of one year who get a urinary tract infection, about a quarter of them will have a recurrence of the urinary tract infection.

Risk factors (causes underlying the disease):

Research has shown that the occurrence of some genes in the human body can make a person susceptible to the recurrence of urinary tract infection, diabetes is also a predisposing factor.

Risk factors in women include:

• marital relationship

• Vaginal dryness caused by menopause

• Structural and anatomical disorders of the urinary system such as (Foley tube, nervous bladder, urinary reflux, urinary tract obstruction and disorders of the anatomical and structural system of the urinary system)

• Inadequate drainage of linen

• Prevention methods such as some condoms and gels

• History of urinary system surgery

• Immunodeficiency such as AIDS

• The first occurrence of a UTI attack before the age of 15

• History of recurrent urinary tract infection in mothers

Risk factors in men include:

• Structural disorders of the urinary system such as: (Foley's tube, nervous bladder, urine reflux, urinary tract obstruction and anatomical and structural system disorders of the urinary system)

• Incomplete bladder emptying, due to enlarged prostate, Foley catheter use, prostatitis)

• History of surgery in the urinary system

• Immunodeficiency such as AIDS

Risk factors in children include:

Any factors that lead to the retention of urine in the urinary system such as:

• • Regurgitation of urine

  • Urinary tract obstruction

• Family history of urinary reflux

• • Urinary disorders

  • Reduced urinary stream (meatal stenosis )

  • constipation

  • Imperfect functioning of the immune system

  • Sexual harassment

• Kidney dysfunction

Purification of disease

Symptoms include heartburn, frequent urination, urge to urinate, nocturia, bloody urine, and pain in the lower abdomen.

In the examination, there may be pain in touching the lower abdomen, cloudy and smelly urine, and in elderly people, incontinence, confusion, loss of appetite, fever, and shock may be seen.

Reviews

In cases of urinary tract infection, a complete urine test and urine culture are necessary to find the type of microbe.

In children, the urine sample should be taken cleanly, and it is much easier to take this sample in children who are able to control their urine.

In children, ultrasound is usually performed first.

Men with recurrent urinary tract infection should be referred to a urologist. People who have blood in the urine need to see a doctor promptly.

In women who have recurrent urinary tract infection with bleeding in the urine, they should refer to a urologist to rule out serious causes, in this category of women, no specific injury, specific abnormality, or specific lesion is usually seen during examinations.

In children, it is necessary to take a photo of the urinary system, including a nuclear photo, and a photo of the bladder with contrast or nuclear material.

CT scan is one of the appropriate examination methods in women with recurrent urinary tract infections, although ultrasound may be used.

In men, for recurrent urinary tract infection, the prostate should be evaluated as well as structural and anatomical disorders of the urinary tract.

In women who come with a urinary tract infection, it is necessary to use a course of antibiotics other than the previous one for a period of 5 to 10 days. If the symptoms are mild and tolerable, wait for 2 or 3 days, and if the symptoms do not improve, start the second antibiotic.

Prevention of recurrent urinary tract infection

In order to prevent frequent urinary tract infections, the following measures are necessary:

• If the urinary tract infection is related to marital relations, it is necessary to check the contraceptive methods and change them if needed.

• During intercourse, it is better to use water-based lubricant gels.

• People who have a history of recurrent urinary tract infections can take cotrimoxazole tablets within 2 hours of sexual intercourse.

• If the frequent urinary tract infection is not related to sex, it is better for such people to take nitrofurantoin or cotrimoxazole in a low dose for a period of 6 months.

• In menopausal women, the benefit of using estrogen creams has not been proven for them, although according to urology experts, such creams are prescribed for some people.

Recent research has shown that there is no evidence that cranberry extract is beneficial, changes in lifestyle such as consuming more fluids and observing other health methods are not effective either.

If a person frequently suffers from urinary tract infections, it is necessary to refer to a urologist for evaluation, counseling and treatment.

men

In men, chlamydia infection should first be checked. Some men have chlamydial urethritis rather than a urinary tract infection; men who are not infected with chlamydia generally need a 7-day course of antibiotics such as nitrofurantoin or co-trimoxazole.

Recurrent bladder infection is usually caused by an underlying condition such as prostate infection, benign prostatic hyperplasia, prostatitis, stones in the urinary system, or urinary reflux.

Recurrent urinary tract infection in children

In children under 3 months with urinary tract infection, it is necessary to refer to a pediatrician for hospitalization

In children over the age of 3 months, the choice of antibiotics is to use oral antibiotics for a period of 3 days, and in those children who have kidney and upper urinary tract infections, it is necessary to continue the period of 7 to 10 days.

In case of recurrent urinary tract infection, the following measures should be taken:

• Constipation and urinary disorders must be treated.

• Adequate consumption of liquids must be observed.

• Those children who do not have access to the toilet or come late should not delay their urination.

Complications

Most people recover after the course of treatment, although recurrent urinary tract infections are a risk factor for kidney infections and can lead to scars or old spots caused by urinary tract infections.

Recurrent urinary tract infections in children can lead to high blood pressure and reduced kidney function in adulthood.