How are Recurrent Urinary Infections treated?

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

  • cranberry supplements
  • oestrogen therapy
  • urethral dilatation
  • prophylactic antibiotics
  • 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, cranberry juice, squash 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.

Cranberry supplements

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Some patients find that drinking cranberry juice regularly can reduce the numbers of infections they get. Studies have shown that taking cranberry juice can reduce the number of infections by about 40%. A large glass of juice is taken twice a day. Cranberry capsules are also available and may be preferable.

Cranberry supplements should be taken with caution if you take Warfarin tablets.

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.

Prophylactic antibiotics

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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.

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.

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