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  • With Mayo Clinic urologist

    Erik P. Castle, M.D.

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Question

Chronic bladder infection: Is there a cure?

I’m a woman who has had a chronic bladder infection for four years. My doctor keeps giving me antibiotics, but the infection keeps coming back. What can I do?

Answer

from Erik P. Castle, M.D.

You're not alone. Various studies have found that between 27 and 50 percent of otherwise healthy women experience at least one recurrent bladder infection (cystitis) within a year of the first infection.

There can be several causes of chronic bladder infections, such as:

  • Kidney or bladder stones
  • Bacteria entering the urethra during sexual intercourse
  • Altered estrogen levels during menopause
  • Abnormal urinary tract shape or function
  • Genetic predisposition

In general, women who have two or more culture-documented bladder infections in a six-month period should be evaluated by a urologist to determine the underlying cause. The evaluation may include:

  • Urine culture of a sample obtained with a catheter
  • Cystoscopy — looking into the bladder with a lighted scope
  • Computerized tomography (CT) scan

Treatment is directed at the underlying cause, when possible. If no source of infection is found, lifestyle modifications combined with vaginal estrogen replacement, if applicable, is all you may need. Lifestyle changes that may reduce your risk of bladder infection include:

  • Drinking plenty of liquids, especially water
  • Urinating frequently
  • Wiping from front to back after urination or a bowel movement
  • Taking showers rather than baths
  • Gently washing the skin around your vagina and anus daily using a mild soap and plenty of water
  • Using forms of birth control other than a diaphragm and spermicides
  • Emptying your bladder as soon as possible after intercourse
  • Avoiding deodorant sprays or scented feminine products in the genital area
  • Drinking cranberry juice, though studies with promising results had limitations

Otherwise, long-term, low-dose, preventive antibiotics is the only treatment option. In such cases, you may need to take antibiotics for as long as six months to two years.

Next question
Bladder infection in men
References
  1. Hooton TM. Recurrent urinary tract infection in women. http://www.uptodate.com/home/index.html. Accessed Sept. 9, 2011.
  2. Dielubanza EJ, et al. Urinary tract infections in women. Medical Clinics of North America. 2011;95:27.
  3. Urinary tract disorders. In: Rakel RE. Textbook of Family Medicine. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2011. http://www.mdconsult.com/das/book/body/191205553-4/0/1481/0.html#. Accessed Sept. 9, 2011.
  4. What I need to know about urinary tract infections. National Kidney & Urologic Diseases Information Clearinghouse. http://kidney.niddk.nih.gov/kudiseases/pubs/uti_ez/. Accessed Sept. 9, 2011.
AN01683 Oct. 5, 2011

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