Recurrent Urinary Tract Infections Associated with Gynecological Disorders.

Recurrent urinary tract infections (UTIs) in women are defined as three or more infections in a 12-month period. They occur commonly and often have a significant impact on quality of life. Although the etiology is multifactorial (including genetic, behavioral, anatomic, and hormonal factors), certain gynecological conditions, such as uterovaginal prolapse with dysfunctional voiding, have a higher disposition to causing UTIs. The clinical evaluation must therefore be comprehensive and include a detailed medical history, a thorough physical and gynecological examination, a full urinalysis including microbiological culturing of the specimen, and appropriate imaging. Antibiotics remain the mainstay of therapy for acute UTIs and also have a role in treatment of recurrent UTIs. Prophylactically, they can be given continuously using a low-dose formula or in the form of self-start treatment or immediately postcoitus. Other useful prophylactic measures include topical estrogen in postmenopausal women and cranberry products. Emergent therapies, such as immunization and probiotics, have a promising future, but their role has yet to be defined. [ABSTRACT FROM AUTHOR]