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Chronic UTIs typically recur within a month after treatment or multiple times in a year. Recurring UTIs can lead to severe complications, but treatment options are available.

Chronic urinary tract infections (UTIs) are infections of the urinary tract that either don’t respond to treatment or keep recurring. They may either continue to affect your urinary tract despite getting the right treatment, or they may recur after treatment.

Your urinary tract is the pathway that makes up your urinary system. It includes the following:

  • kidneys, which filter your blood and generate body waste in the form of urine
  • ureters are tubes carrying urine from the kidneys to the bladder
  • bladder collects and stores urine
  • urethra is the tube that carries urine from the bladder to the outside of your body

A UTI can affect any part of your urinary system. When an infection only affects your bladder, it’s usually a minor illness that you can easily treat. However, if it spreads to your kidneys, you may deal with serious health consequences or need hospitalization.

Although UTIs can happen to anyone at any age, their prevalence is higher in females.

The symptoms of a chronic UTI affecting your bladder include:

  • frequent urination
  • bloody or dark urine
  • a burning sensation while urinating
  • pain in your kidneys, which means in your lower back or below your ribs
  • pain in your bladder region

If the UTI spreads to your kidneys, it might cause:

People who live with chronic UTIs may also experience complications. Recurring urinary tract infections may eventually cause:

  • kidney infections, kidney disease, and other permanent kidney damage, especially in young children
  • sepsis, which is a life threatening complication due to infection
  • septicemia is a condition in which bacteria have entered the bloodstream
  • increased risk of premature delivery or of having babies with low birth weight

A UTI is the result of a bacterial infection. In most cases, the bacteria enter the urinary system through the urethra and then multiply in the bladder.

Breaking down UTIs into bladder and urethral infections helps us better understand how they develop.

Bladder infections

The bacteria Escherichia coli (E. coli) is a common cause of infections of the bladder or cystitis. E. coli usually live in the intestines of healthy people and animals.

In its usual state, it doesn’t cause any problems. However, if it finds its way out of the intestines and into the urinary tract, it can lead to an infection.

This usually happens when tiny or even microscopic bits of feces get into the urinary tract. This might happen during sex. For example, this can happen if you switch between anal and vaginal sex without cleaning in between.

Anal sex increases your UTI risk significantly. Bladder infections can also develop from toilet water backsplash or improper wiping. Foamy urine can also signal an issue.

Urethral infections

Also known as urethritis, infections of the urethra could be due to bacteria such as E. coli. Urethritis can also be the result of a sexually transmitted infection (STI). However, this is rare. STIs include:

Being female

Chronic UTIs are most common in females. This is due to two different aspects of basic human anatomy.

First, the urethra is close to the rectum in females. As a result, it’s easier for bacteria from the rectum to reach the urethra, particularly if you wipe back to front instead of front to back. This is why young girls often get UTIs. They haven’t learned how to wipe properly.

Second, the female urethra is shorter. This means that bacteria have a shorter distance to travel to get to the bladder, where they can multiply and more readily cause infection.

Lifestyle

Lifestyle factors can put you at extra risk of developing a chronic UTI, such as using a diaphragm during sex. Diaphragms push up against the urethra, making it harder to fully empty your bladder. The urine that doesn’t empty is more likely to grow bacteria.

Another example is constantly changing the bacterial makeup of the vagina. This can increase your risk of developing a chronic UTI. If you regularly use any of the following products, then you’re changing your vaginal bacteria:

Menopause

Menopause can cause similar problems in some people. Menopause causes hormone changes that can cause changes in your vaginal bacteria. This can increase your risk of chronic UTIs.

Medications

A course of antibiotics delivered over 1 week is the primary treatment for UTIs.

However, if you have chronic UTIs, your doctor may likely prescribe long term, low dose antibiotics for more than 1 week after the initial symptoms subside. In many cases, this helps prevent symptoms from recurring.

Your doctor may also recommend a course of treatment in which you take antibiotics after each time you have intercourse.

In addition to antibiotics, your doctor will want you to monitor your urinary system more closely. For example, they may ask you to perform regular home urine tests to check for infections.

If your chronic UTIs occur with menopause, you may want to consider vaginal estrogen therapy. This can limit your risk for future UTIs, although it does have some tradeoffs. Be sure to discuss it with your doctor.

If you have an active infection, you may experience burning while urinating. Your doctor may prescribe pain medication to numb your bladder and urethra. This will reduce the burning sensation.

Your doctor may also prescribe other medications for treatment that are not antibiotic-based.

Natural remedies

According to a 2023 review, drinking cranberry juice daily can help minimize recurrences among those who have chronic UTIs.

Another natural remedy for treating a UTI is drinking plenty of water. Water can help dilute urine and flush out bacteria in the urinary tract.

If you’re experiencing pain, placing a heating pad or hot water bottle on your bladder may provide you relief.

Consider visiting our resource page for more information on treating a UTI without antibiotics.

UTI Supplement Options

Read our full review of Uqora, a company that focuses on developing natural supplements for UTI prevention.

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If you’re prone to recurring UTIs, make sure to:

  • urinate more often (especially after intercourse)
  • wipe front to back after urinating
  • drink plenty of water to flush bacteria out of your system
  • drink cranberry juice daily
  • wear cotton underwear
  • avoid tight-fitting pants
  • avoid using diaphragms and spermicides for birth control
  • avoid drinking fluids that may irritate your bladder (such as coffee, citrus fruit drinks, soda, alcohol)
  • use lubrication during sex, if necessary
  • avoid bubble baths
  • wash your foreskin regularly if you’re uncircumcised

A common method that doctors use to diagnose UTIs is performing lab tests on a urine sample. A medical professional examines the sample under a microscope, looking for the presence of bacteria.

In a urine culture test, a technician places a urine sample in a tube to help the bacteria to grow. After 1 to 3 days, they look at the bacteria to determine the best treatment.

If your doctor suspects kidney damage, they may order X-rays and kidney scans. These imaging devices take pictures of parts inside your body.

If you have recurring UTIs, your doctor may want to perform a cystoscopy. In this procedure, they’ll use a cystoscope. It’s a long, thin tube with a lens at the end used to look inside your urethra and bladder.

Your doctor will look for any abnormalities or issues that could cause the UTI to keep coming back.

Urinary tract infections are uncomfortable and painful. Most chronic UTIs will resolve with a prolonged course of antibiotics, but monitoring for further symptoms is important since they usually recur.

People with UTIs should monitor their bodies and seek immediate treatment at the start of a new infection. Early treatment decreases your risk of more serious, long-term complications.