Symptoms of UTIs range from painful urination to fever and flank pain.

Did you know that up to 50 per cent of women will experience at least one urinary tract infection (UTI) in her lifetime? What’s more, 20 to 40 per cent of those afflicted will also face the challenge of recurrent UTIs.

A UTI is an infection in any part of the urinary system and comes with symptoms such as painful urination, cloudy urine, frequency in urination and feeling the need to urinate even though the bladder is empty. 

Dr Tricia Kuo, consultant urologist at Urohealth Medical Clinic, says: “Should the infection ascend and cause infection in one or both kidneys, then symptoms can also include fever and pain in the flank.”

Recurrent UTIs are classified as three or more UTIs within a 12-month period or two or more within a six-month timeframe, and can pose a significant disruption to your daily life. Understanding the causes and adopting effective prevention methods is key to living UTI-free.

Why do some women experience recurrent UTIs?

You may already be aware of certain lifestyle habits that contribute to recurrent UTIs. These include not wiping properly after peeing, which encourages bacteria to grow in the genital area, holding in your urine for long periods of time and not drinking enough water, which leads to a higher concentration of bacteria in the urinary tract.

Dr Kuo points out that using panty liners when not menstruating also traps bacteria around the genital area, while excessive use of feminine washes or sprays can disrupt the natural microbiome and healthy bacteria.

Other risk factors for recurrent UTIs include sex, anatomical abnormalities, such as a urethral diverticulum or a urethral stricture, chronic medical conditions that lower immunity such a poorly controlled diabetes or autoimmune disorders, and hormonal changes.

“Hormonal changes during menopause can lead to thinning of the vaginal lining and a decrease in protective bacteria, making the urinary tract more susceptible to infection,” explains Dr Kuo, “while sexual activity can cause bacteria to be pushed into the urethra, increasing the risk of infection”.

What are the best ways to treat recurrent UTIs?

Treating recurrent UTIs involves a combination of medical intervention and lifestyle changes. 

Dr. Kuo recommends drinking at least one-and-a-half to two litres of water per day to flush out the bad bacteria, increasing your intake of immune-boosting antioxidants – such as Vitamin C and Vitamin D – and taking cranberry products which contain compounds that prevent bacteria from sticking to the walls of the urinary tract. Consuming more probiotics also helps promote the growth of healthy bacteria in the gut and urinary tract. 

Drinking cranberry juice or taking cranberry supplements can help alleviate UTI symptoms.
Drinking cranberry juice or taking cranberry supplements can help alleviate UTI symptoms.

“However, if someone has an active UTI, it’s advisable to avoid citrus or other acidic foods as these can irritate the bladder further,” she says. “Additionally, cut down on bladder irritants like caffeine, alcohol, spicy food, nicotine, carbonated drinks and artificial sweeteners.”

The standard medical treatment for recurrent UTIs are antibiotics prescribed by a healthcare professional. However, Dr Kuo says that antibiotic resistance resulting from the overuse or misuse of antibiotics can make treating recurrent UTIs more challenging. 

Should therapeutic options be insufficient, a UTI vaccine may help. “Vaccines are used for patients with uncomplicated recurrent UTI, which implies that there is no other underlying anatomical or functional abnormality detected in the urinary tract,” she explains. 

How do vaccines work to prevent recurrent UTIs?

UTI vaccines work by training your immune system to recognise and attack the bacteria that cause the infection before they can take hold, explains Dr Kuo. It usually contains small, inactivated forms of the bacteria, which are generally harmless but can still trigger an immune response.   

By activating the immune system, vaccines help to reduce the number of UTIs, prevent its recurrence, as well as delay the onset of new UTI episodes. While many people would usually think that vaccines are administered via injections, UTI vaccines can also be administered orally. 

However, Dr Kuo stresses that those with an active UTI should still take a short course of antibiotics to eradicate the bacteria before starting any vaccine. 

For patients with recurrent UTI, she highlights the importance of a thorough assessment of their urinary tract before considering vaccines. This typically includes a physical examination, scans, urine flow tests and sometimes other specialised tests.

“As always, prevention is better than cure. Reducing risk factors and paying attention to contributing triggers, such as habitual holding of urine, can go a long way in maintaining good urinary health,” she adds.

If you suffer from UTIs or recurrent UTIs, it is recommended that you consult with a urologist to discuss the appropriate treatment. For more information, visit Urohealth Medical Clinic’s website.

A Urohealth Medical Clinic special, brought to you by The Singapore Women's Weekly