Stubborn Urinary Tract Infections

Women are often troubled by repeated urinary tract infections (UTIs). Men have fewer troubles with UTIs because their urethral opening is further from their anus than that of women. That is the reason women are instructed to wipe themselves from front to back.

If you are troubled by repeated urinary tract infections, your doctor needs to determine whether you have a urinary tract infection which a course or two of antibiotics fails to cure, or whether you are recovering from the UTIs with a course of antibiotics, but for some reason become re-infected quickly.

The best way to tell if you have a UTI is to have a urine sample cultured. If you keep getting UTIs, your doctor may want to get a sterile urine sample for culturing. This requires catheterization. Culturing your urine sample will determine the precise name of the bacterium causing your UTI as well as the specific medication which is appropriate to treat the specified infection.

To be sure you are recovering from the UTI, get a second urine culture after you have finished taking your medication. In addition to being sure you are wiping front to back, abstain from intercourse for a week before the second urine culture. This second urine culture will tell you whether or not you have recovered from your urinary tract infection.

Treatments are different for these two different types of UTIs. With frequent UTIs, you need to make sure that you are doing what is necessary to prevent reinfection. Sometimes women get UTIs from having intercourse. It has been postulated that many women will get a UTI for a short time after intercourse but recover from the UTI all on their own. The question becomes then, why some women don’t recover on their own.

Some women have symptoms as if they have a UTI but there is no evidence in a urinalysis or urine culture that they have a UTI infection. There are atypical conditions and atypical infections. You want to make sure you don’t have anything like gonorrhea, chlamydia, or Group B strep. These organisms would ordinarily show up in a urinalysis and a urine culture. However, there are other organisms such as ureaplasma and mycoplasma which are not normally checked for in a urine culture. These two bacteria are often overlooked as causes of problems because they are so common, they are considered colonizers, that is, assumed to be present in everyone.  However, some women do have reactions to these bacteria, but your doctor will have to specify in the lab order to look for these organisms in a urine culture.

Not all symptoms of UTI are caused by bacteria. If you have UTI symptoms but no bacterial evidence for a UTI can be found, you could have urethritis, which is an inflammation in the muscle of the urethra. Or you could have interstitial cystitis which is an inflammation in the muscle of the bladder wall.

UTIs can be difficult to diagnose and to treat, depending upon whether the UTI is cured but then shows up again, or whether the UTI doesn’t respond to the treatment. Or you have symptoms of a UTI, but no positive tests for one. Just know that if you are bothered by repeated UTIs, your doctor can determine the cause of the UTI or the symptoms of a UTI, but it may take several diagnostic tests to determine the precise cause.