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How are Recurrent Urinary Infections treated?

Many women find they can control their infections with simple lifestyle changes. Other treatments are sometimes required. These include:

  • nutritional supplements
  • oestrogen therapy
  • urethral dilatation
  • tablets and medications
  • other therapies

Conservative measures

There are a number of things you can do to prevent urinary tract infections:

  • Avoid holding on to the urine for long periods.
  • Have at least eight to ten drinks (mug-size) daily. These could be water, juice or other fluids.
  • Shower instead of taking a bath. Avoid using bubble bath or other cosmetic bath products.
  • Avoid using any feminine hygiene sprays and scented douches.
  • Empty your bladder after sexual intercourse, as intercourse can often trigger an infection.
  • After going to the toilet, wipe from front to back.

Dietry supplements

We used to recommend that drinking cranberry juice regularly can reduce the numbers of infections patients get. Recent studies have shown that cranberry juice does not reduce infections unfortunately.

D-Mannose tablets are available from some internet suppliers, and there is emerging evidence that this is effective in reducing urinary infections if taken regularly.

Oestrogen treatments

Oestrogen (a female hormone) may have a protective effect against urinary infections. After the menopause (when the periods have stopped), the oestrogen levels in the body diminish. This can make some women more susceptible to urinary infections, even if they take HRT. Studies have shown that vaginal oestrogen replacement can reduce the number of infection by between 40 and 75%.

Your doctor may recommend treatment with oestrogen pessaries, or a vaginal oestrogen cream.

Urethral dilatation

This is a surgical procedure that can often be performed as a day-case. After an anaesthetic has been given, your surgeon will perform a bladder inspection with a telescope (cystoscopy) and will gently stretch the urethra (water pipe). About 70% of women with recurrent urinary infections find that they get significantly fewer infections following this procedure.

Tablets and medications

Studies have shown that a small dose of antibiotic taken every day can reduce the number of infections. This type of treatment is not appropriate for everyone and it is advisable to discuss things with a specialist before starting. The treatment usually needs to be continued for many months or even longer.

For some people, a small dose of antibiotics taken immediately before or after sexual intercourse can be equally as effective as taking antibiotics every day.

Studies have shown that prophylactic antibiotics can reduce the number of infections by up to 85%. Some patients find that they are more susceptible to getting thrush (candida infection) while taking long-term antibiotics.

An alternative to antibiotics is a medicine called Methanamine. This is a tablet that is taken twice daily. It produces an antiseptic that comes out into the urine and can stop bacteria building up. It is a good alternative to antibiotics, although it is less effective.

Other Treatments

Acupuncture can be effective in treating recurrent urinary infections. Your specialist will be able to advise you how this can be arranged.

Although probiotics have been used successfully to treat patients with recurrent urinary infections, taking oral probiotics is not usually effective.