What Is a Recurrent UTI, and When Should You See a Specialist?

Urinary tract infection (UTI) is a common condition. It occurs when bacteria enter the body through the urethra, which carries urine out of the body. The bacteria then spread through the urinary tract. A UTI will most commonly affect the bladder, making it painful to pee. People with UTIs also often have the sudden urge to pee.

UTIs are especially common in women. Antibiotics will usually treat them. But UTIs can come back even after treatment. When you have frequent UTIs, it’s known as recurrent UTIs. And some women are prone to getting UTIs more frequently than others. Learn about why this happens, how to treat recurrent UTIs, and prevent it. 

What are recurrent UTIs and what causes them?

Recurrent UTI is defined as 3 or more UTIs in 1 year, or more than 2 UTIs in 6 months. More research is needed to understand why some people get frequent UTIs. But there are some risk factors that may make it more likely. Having a history of any of the following could put you at greater risk:

• A female sibling, child, or parent with recurrent UTIs 

• Sexual intercourse three or more times per week

• Sex with new or many partners

• First UTI before age 15

• Spermicide use

• Menopause

• Diabetes

• Trouble emptying your bladder completely

How common are recurrent UTIs?

UTIs are one of the most common bacterial infections. In fact, 40% to 60% of women are likely to have at least one UTI in their lifetime. But recurrent UTIs are also common. Recurrent UTIs are when you have at least 2 UTIs within 6 months. Over 1 in 3 of women will experience another UTI within months of their first one.

How are recurrent UTIs diagnosed?

Healthcare providers will diagnose recurrent UTIs in the same way as your first UTI. The symptoms are the same, and urine testing can confirm the diagnosis. 

If you have another UTI within 2 weeks of the last one, it might mean that the last antibiotic didn’t work. Your provider may ask for a urine sample to send for a urine culture. This is a test to see exactly the type of bacteria that grows from your urine. It will also show which antibiotics will work against the bacteria. 

Imaging tests are not needed unless you have other symptoms. Your provider may suspect you have something blocking the flow of urine, like a kidney stone. In this case, they may recommend imaging like X-rays or an ultrasound.

What is the treatment for recurrent UTIs?

The treatment for a recurrent UTI is the same as treatment for a first-time UTI: antibiotics. Some recommended antibiotics for recurrent UTI include:

• Nitrofurantoin (Macrobid)

• Trimethoprim-sulfamethoxazole (Bactrim) 

• Fosfomycin (Monurol)

• Ciprofloxacin (Cipro)

• Cefpodoxime

• Cefuroxime

How many days you’ll have to take the antibiotics depends on the prescription. But it’s usually 3 to 7 days. If you get a prescription for antibiotics, be sure to take the entire medication. Don’t save any pills for later or share them with a friend. Talk to your healthcare provider if you don't feel better after a few days on antibiotics.

What should you do if you still have UTI symptoms after taking antibiotics?

If you feel like your UTI has not resolved after taking antibiotics, let your provider know. There are several reasons this can happen, including: 

• You may have an infection caused by a bacteria that’s resistant to your antibiotic.

• There may be another type of germ — like fungi or viruses — causing the infection.

• Your UTI symptoms could be from another condition — like sexually transmitted infection).

In some cases, you may need a longer course of treatment or a different antibiotic. Or you may need a different treatment altogether. Your provider can help with the testing needed to understand your UTI symptoms.

What is the difference between chronic and recurrent UTIs?

Chronic UTI means there are ongoing symptoms despite treatment. This is unlike recurrent UTIs where the symptoms go away between infections.

Experts believe that symptoms in chronic UTIs are because bacteria are still present. This is even if they don’t show up on a urine culture. So if you have other signs of infection, your provider may treat your ongoing UTI symptoms. 

How do you prevent recurrent UTIs?

For women with recurrent UTIs, regular antibiotic use can prevent UTIs (antibiotic prophylaxis). This means taking an antibiotic every day, or taking it only when needed. For example, women who get UTIs only after sex may take an antibiotic each time they are sexually active.

It’s not clear how long antibiotic prophylaxis should go on. And taking antibiotics for a long time can make it harder for them to work for you. If you have recurrent UTIs, speak with your healthcare provider about your options.

Aside from antibiotics, there are also several things you can do to prevent UTIs, including:

• Drinking plenty of water each day

• Emptying your bladder right after sex

• Using contraception that doesn’t involve spermicide

• Doing vaginal estrogen therapy (if you have gone through menopause) 

Can recurrent UTIs be a sign of cancer?

Cancer of the urinary tract and recurrent UTI can have similar symptoms. The most common sign of bladder cancer is blood in the urine — which is also a symptom of UTIs. And it may also be painful to pee. So it can be hard to tell. 

Although some women tend to have recurrent UTIs, this doesn’t mean something serious. That said, you should listen to your body if it’s telling you something different. Some more signs and symptoms that something more serious may be going on include:

• Difficulty urinating

• Bone pain

• Severe pain in your back or side

• Weight loss

• Swollen lymph nodes

If you have any of these symptoms and frequent UTI, talk to your healthcare provider right away. They will need to make sure you don’t have a more serious condition.

Some evidence shows a link between recurrent UTIs and cancer of the urinary tract. But it’s extremely rare. There's higher risk after menopause for women who smoke and for men who've been on antibiotics. More research is needed to see who is more likely to be at risk of developing cancer from recurrent UTIs.

When should you see a specialist for recurrent UTIs?

You don’t always need to see a specialist for recurrent UTIs. But there are certain situations where you might need further testing, like if you:

• Continue to have UTI symptoms after treatment and your urine culture does not grow any bacteria

• Have blood in your urine after finishing treatment

• Have had surgery on your genital or urinary system before

• Have had a kidney infection more than once

• Have had a kidney stone before

• Have trouble controlling or completely emptying your bladder 

Tell your provider about previous UTIs and any lingering symptoms after treatment. They can decide if you need more testing or to see a specialist for UTIs.

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Written by:

Mandy Armitage, MD

Mandy Armitage, MD, has combined her interests in clinical medicine with her passion for education and content development for many years. She served as medical director for the health technology companies HealthLoop (now Get Well) and Doximity.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

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