Investigation and managemenet of recurrent urinary tract infection

U rinary tract infections (UTIs) are common, especially in women, and account for about 17 per 1000 GP consultations.1 Approximately one-third of women who have an initial UTI will have a recurrence, mostly in the absence of any anatomical abnormality of the urinary tract. Recurrences are much less common in children and men and suggest the presence of a predisposing abnormality. Recurrent UTI is defined as three or more infections within 12 months, or two or more infections within six months. Investigations for recurrent UTI aim to identify predisposing causes and prevent long-term complications. Selection of investigations is guided by history and examination findings and patient age and sex. Most patients are able to managed in general practice and do not require specialist referral.