Recurrent UTIs and cystitis symptoms in women

BACKGROUND: Recurrent urinary tract infections (rUTIs) and recurrent cystitis symptoms without infection occur commonly in women and present frequently in general practice. OBJECTIVE: The aim of this article is to provide a management approach to the assessment and treatment of recurrent cystitis symptoms in women with rUTIs as well as women who have negative urine cultures. DISCUSSION: Five common clinical scenarios are discussed with different approaches to treatment: true rUTIs with positive urine cultures, women with variable urine cultures (some positive and some negative), women with negative urine cultures who have pyuria +/- haematuria, women with completely normal urine cultures and women with ongoing symptoms after a definite UTI. Red flags signalling the need for early referral to a urologist for further assessment are discussed. Both non-antibiotic and antibiotic-related strategies to treat women with rUTIs are available.