Overview

Recurring urinary tract infection (UTI) can also be referred to as chronic or persistent bladder infection. It is usually diagnosed if you had 3 cystitis episodes with positive urine cultures in the past 12 months, or 2 infections in the past 6 months.

UTIs affect women much more than men - between 50 and 60% of women will develop a UTI in their lifetime (although they may not recur).

Symptoms

If you develop a bacterial bladder infection, you may feel the following symptoms:

• You may need to pee more often than usual,
• You may feel continuous urinary urgency,
• Even after urinating, you may feel as if you haven’t emptied your bladder,
• You may feel pain, burning or pressure while urinating,
• Pain may also occur in your lower back or in your stomach,
• Your urine may be cloudy, have an unpleasant, strong smell or traces of blood.

All of these symptoms will be accompanied by a positive urine culture.

If the infections spreads onto the kidneys, you may feel nauseated, develop fever or feel tired and weak.

Causes

Factors which may contribute towards developing a bacterial infection of your bladder:

• Inappropriate hygiene (wiping from back to front after using the toilet),
• Having sex (especially anal sex),
• Hormonal changes during menopause, pregnancy or while using oral contraception,
• Even though men rarely get UTIs, when they do occur, usually the cause is an enlarged prostate,
• Genetic factors and urinary tract abnormalities.

Diagnosis

As we have mentioned previously, if you had 3 infections in the past year, or 2 episodes in the last 6 months, your doctor will probably diagnose a recurrent UTI. To confirm that your symptoms are caused by a bacterial infection in the bladder, your doctor may request urine culture, cystoscopy of the urethra and the bladder. In some cases, a CT scan of the urinary tract may be required.

Treatment

First line of treatment for a bacterial bladder infection is a dose of antibiotics. However, using antibiotics frequently creates the risk of developing bacterial resistance. That is why the NICE guidelines recommend exploring alternative treatment options which will not cause resistance, such as 0.2% chondroitin sulphate instillation (Gepan).

How can Gepan help?

Damage to the protective layer of the bladder may facilitate frequent bladder infections allowing bacteria to easily adhere to the bladder wall. Gepan can temporarily supplement the damaged bladder wall, making it more difficult for bacteria to adhere to it, thus protecting against new infections.

In one of the clinical studies, Gepan was compared to antibiotic treatment of recurrent cystitis. Gepan on its own significantly reduced the number of infections compared to both antibiotics alone, and combination of Gepan and antibiotics. Quality of life improved, and the patients didn’t have to visit their doctors as often*.

Mr Prasad Patki, Clinical Lead of Urology at Barts Hospital, London, said: