State-of-the-Art Review: Recurrent Uncomplicated Urinary Tract Infections in Women

Abstract

Over 50% of adult women experience at least 1 urinary tract infection (UTI) in their lifetime, and almost one-quarter of them will experience a recurrent UTI (rUTI). Recurrent UTI is defined as ≥2 UTIs in a 6-month period or ≥3 UTIs in 12 months (at least 1 of these episodes should be culture-proven to confirm infectious etiology). In this narrative review, we discuss the epidemiology, pathogenesis, diagnosis, and treatment considerations for recurrent uncomplicated cystitis in the adult female population. We provide a focused overview of the comprehensive management of these patients, with input from infectious disease physicians, urogynecologists, and urologists with expertise in rUTI, highlighting updated recommendations by the Infectious Diseases Society of America, American Urologic Association, Canadian Urologic Association, and American Urogynecologic Society. Finally, given the variety of prevention strategies, different treatment goals, and the need for "preference sensitive" decisions, we highlight the need for shared decision-making with patients.

Keywords: LUTS; asymptomatic bacteriuria; chronic UTI; recurrent UTI; recurrent cystitis.