Recurrent Urinary Tract Infection

Diagnosis of recurrent urinary tract infections requires a complete patient history and physical, as well as documentation of urine cultures and sensitivity tests. Women should undergo a pelvic examination to search for signs of cystoceles, vaginitis, vaginal atrophy, and pelvic organ prolapse while men should be evaluated for prostatitis. Symptoms of the current urinary tract infection should be examined to differentiate between simple and complicated cystitis. Patients with acute simple cystitis will present with urinary frequency, dysuria, and suprapubic pain. Patients with acute complicated cystitis may experience fever, chills, rigors, and general malaise. Another important distinction in diagnosis is whether current urinary tract infection is a relapse or reinfection. It is classified as a recurrence if the patient is reinfected with a new bacterial organism more than two weeks after the first infection. The patient has a relapse when, within two weeks from the first episode, the patient develops symptoms from the same bacterial organism due to incomplete treatment of the first episode.