Recurrent urinary tract infection (UTI) is defined as a urinary tract infection occurring two or more times within 6 months or three or more times within one year.

According to Associate Professor, Doctor, Level II Specialist Pham Thanh Truc, from the Urology - Nephrology - Andrology Center at Tam Anh General Hospital Ho Chi Minh City, many patients mistakenly believe UTIs are common ailments that can be cured simply by taking medication. However, prolonged antibiotic use without a proper regimen, self-discontinuation of medication upon feeling better, or failure to seek the root cause (such as stones, urinary tract malformations, or underlying diseases) prevents bacteria from being completely eradicated, leading to recurrent outbreaks.

Doctor Truc consults a patient about urinary tract infection. *Photo: Tam Anh General Hospital*

Doctor Truc notes that recurrent UTIs can affect anyone. When infections persist, the urinary tract suffers continuous damage, leading to a loss of its natural protective barrier. This allows bacteria to penetrate deeper into internal organs. Without accurate diagnosis and definitive treatment, the condition can lead to severe complications.

One of the most concerning complications, according to Doctor Truc, is acute and chronic pyelonephritis (kidney inflammation). Bacteria from the bladder can ascend to the kidneys, causing inflammation of the renal parenchyma and renal pelvis. Patients typically experience high fever, chills, lower back pain, and general fatigue. If this condition recurs without complete treatment, the renal parenchyma will be damaged, leading to kidney scarring. The long-term consequence is a decline in kidney filtering function, progressing to chronic kidney failure, which severely impacts the patient's health and lifespan.

Recurrent UTIs also promote the formation of urinary stones. Persistent inflammation alters urine pH, creating a favorable environment for mineral crystals to precipitate. Inflammatory cellular debris combined with bacterial remnants form stones in the bladder or kidneys. Stones cause pain and urinary obstruction and serve as a "reservoir" for bacteria, making infections harder to treat and more prone to recurrence.

For individuals with weakened immune systems or underlying conditions like diabetes or immune deficiency, UTIs can progress rapidly. Bacteria from the urinary system can directly enter the bloodstream, leading to sepsis, septic shock, multiple organ failure, and becoming life-threatening if not promptly treated.

Furthermore, prolonged infection can irritate the bladder lining, causing urinary disorders such as overactive bladder or urinary incontinence. Patients frequently experience frequent urination, painful urination, and nocturia (frequent nighttime urination), leading to sleep disturbances, anxiety, and social avoidance.

To definitively treat UTIs, patients must be persistent and strictly follow their doctor's instructions. Patients should consult a urology specialist for proper diagnosis and treatment. Self-medicating with antibiotics without a prescription is strongly advised against, as it can lead to antibiotic resistance and mask symptoms, complicating diagnosis.

Doctors may order necessary tests such as: urine culture to accurately identify bacterial strains, ultrasound or CT, MRI scans to rule out obstructions like stones, tumors, or malformations, and cystoscopy to examine the bladder lining, foreign bodies, or growths within the bladder. This allows for the development of an appropriate treatment plan.

Maintaining habits such as drinking enough water, not holding urine, and undergoing regular health check-ups helps prevent urinary tract diseases.

Bao Anh