Review Recurrent urinary tract infection in gynaecological practice Authors Neil Harris / Roderick Teo / Christopher Mayne / Douglas Tincello Key content: • Urinary tract infection (UTI) is the result of interaction between host defences and bacterial pathogenic mechanisms. • Recurrent UTI can be associated with urinary tract abnormalities. • Urinary tract imaging is useful in a minority of women to identify pathological, structural or functional abnormalities. • Adequate fluid intake, topical estrogens and prophylactic antibiotics can be useful in the management of recurrent infections. • Symptoms often reappear despite adequate treatment. Learning objectives: • To understand the pathogenesis of recurrent UTI in women. • To appreciate the value and limitations of urinary tract imaging. • To develop an appropriate management strategy. Ethical issues: • Women with dipstick haematuria, but without bacteriological confirmation of a UTI, should be referred for urological evaluation. • There is no evidence that the risk of altering antibiotic resistance patterns through the use of prophylactic antibiotics outweighs the advantage of reducing UTI in susceptible individuals. Keywords midstream specimen of urine (MSSU) / prophylactic antibiotics / recurrent urinary tract infection / topical estrogens Please cite this article as: Harris N, Teo R, Mayne C, Tincello D. Recurrent urinary tract infection in gynaecological practice. The Obstetrician & Gynaecologist 2008;10:17–21. Author details 17 Review 2008;10:17–21 10.1576/toag.10.1.017.27372 www.rcog.org.uk/togonline The Obstetrician & Gynaecologist © 2008 Royal College of Obstetricians and Gynaecologists Neil Harris MD FRCS(Urol) Clinical Fellow in Female Urology Department of Urogynaecology, Leicester General Hospital, Gwendolen Road, Leicester LE5 4PW, UK Roderick Teo MRCOG Subspecialty Trainee in Urogynaecology Department of Urogynaecology, Leicester General Hospital. Christopher Mayne FRCOG Consultant Urogynaecologist Department of Urogynaecology, Leicester General Hospital. Douglas Tincello MD FRCOG Senior Lecturer and Honorary Consultant Urogynaecologist Reproductive Science Section, Cancer Studies and Molecular Medicine, Leicester Royal Infirmary, Leicester LE2 7LX, UK Email: dgt4@le.ac.uk (corresponding author)