What Is a Chronic Urinary Tract Infection?
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
Your urinary tract is the pathway that makes up your urinary
system. It includes the following:
- Your kidneys are the organs that filter your
blood and generate body waste in the form of urine.
- Your ureters are the tubes that carry urine from
the kidney to the bladder.
- Your bladder is the organ that collects and
- Your 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 can be
easily treated. However, if it spreads to your kidneys, you may suffer from
serious health consequences and may even need to be hospitalized.
Although UTIs can happen to anyone at any age, they’re more
prevalent in women. In fact, the National
Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) estimates
that one in five young adult women have recurring UTIs.
What Are the Symptoms of a Chronic Urinary
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 the ribs
- pain in your bladder region
If the UTI spreads to your kidneys, it might cause:
- a high fever (over 101°F)
- mental disorientation
What Are the Types of Chronic Urinary Tract
A UTI is the result of a bacterial infection. In most cases, the
bacteria enter the urinary system through the urethra, and then they multiply
in the bladder. It’s helpful to break down UTIs into bladder and urethral
infections to better understand how they develop.
The bacteria Escherichia coli almost always cause infections of the bladder, or
cystitis. E. coli is a type of bacteria that normally live in
the intestines of healthy people and animals. In its normal 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 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 by improper wiping.
Also known as urethritis, infections of the urethra could be due
to bacteria such as E. coli, but can also be the result of a
sexually transmitted infection (STI) such as herpes, gonorrhea, or chlamydia.
STIs rarely cause bladder infections.
Who Is at Risk for a Chronic Urinary Tract
Chronic urinary tract infections are most common in women. This
is due to two different aspects of basic human anatomy.
First, the urethra is close to the rectum in women. As a result,
it’s extremely easy 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 just yet.
Second, a woman’s urethra is shorter than a man’s. This means
that bacteria have a shorter distance to travel to get to the bladder, where
they can multiply and more readily cause infection.
There are lifestyle factors that can put you at extra risk of
developing a chronic UTI.
For example, using a diaphragm during sex can cause problems. 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. If you regularly use antibacterial vaginal douches, spermicides,
and certain oral antibiotics, then you’re changing your vaginal bacteria
regularly. This can increase your risk of developing a chronic UTI.
Menopause can cause similar problems in some women. Menopause
causes hormone changes that in turn can cause changes in your vaginal bacteria.
This can increase your risk of chronic UTIs.
How Is a Chronic Urinary Tract Infection
If you have a chronic UTI, you probably had a UTI in the past.
Performing lab tests on a sample of urine is the most common method
doctors use to diagnose UTIs. A medical professional will examine the sample
for signs of bacteria in the urine using a microscope.
In a urine culture test, a technician places a urine sample in a
tube to encourage the growth of bacteria. After one to three days, they’ll look
at the bacteria to determine the best treatment measure.
If your doctor suspects kidney damage, they may order X-rays and
kidney scans. These are imaging devices that take pictures of parts of your
If you have recurring UTIs, your doctor may want to perform a
cystoscopy. In this procedure, they’ll use a cystoscope, which is a long, thin
tube with a lens at the end, 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.
How Is a Chronic Urinary Tract Infection
A course of antibiotics delivered over one week is the primary
treatment for UTIs.
However, if you have chronic UTIs, your doctor will likely
prescribe long-term, low-dose antibiotics for more than one 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.
have shown that drinking cranberry juice daily can help minimize recurrences
among those who have chronic UTIs. More research needs to be done, but it can’t
hurt if you enjoy the taste. However, talk to your doctor first if you take
If you’re currently infected, you may experience burning while
urinating. Your doctor may prescribe pain medication to numb your bladder and
urethra. This will reduce the burning sensation. Placing a heating pad or hot
water bottle on your bladder may also ease the pain.
What Are the Complications Associated with a
Chronic Urinary Tract Infection?
People who suffer from chronic UTIs may 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, which is a condition in which
bacteria have entered the bloodstream
- an increased risk of premature delivery or of
having babies with low birth weight
What Is the Long-Term Outlook?
Urinary tract infections are uncomfortable and painful. However,
symptoms usually go away with treatment. People with UTIs should monitor their
bodies and seek immediate treatment with the onset of a new infection. Early
treatment of infection decreases your risk for more serious, long-term
How Can I Prevent a Chronic Urinary Tract
If you’re susceptible to recurring UTIs, make sure to:
- urinate as often as needed (especially after
- wipe front to back after urinating
- drink plenty of water to flush bacteria out of
- drink cranberry juice daily
- wear cotton underwear
- avoid tight-fitting pants
- avoid using diaphragms and spermicides for birth
- use lubrication during sex, if necessary
- avoid bubble baths
foreskin regularly if you’re uncircumcised