[Recurrent urinary tract infection in women]

Recurrent urinary tract infections (R-UTI) are common among women even though they generally have a normal urinary tract. Women with R-UTI have an increased susceptibility to vaginal colonization with uropathogens due to a greater propensity for them to adhere to their epithelial cells. Risk factors include frequent sexual intercourse, spermicide use, first UTI at an early age and maternal history of UTI. Prevention of recurrences can be done with low-dose continuous antimicrobial prophylaxis or with post-coital antimicrobial prophylaxis, a method that may be more efficient and acceptable. Estrogen replacement therapy using a vaginal administration in postmenopausal women is also effective in preventing R-UTI. The vaginal vaccine only diminishes percentage of women with Escherichia coli UTI. The oral vaccine reduces R-UTI with inferior results than antimicrobial prophylaxis; Cranberry intake shows some evidence in favor, although further trials are needed. Finally R-UTI can also be effectively managed with self-start antimicrobial therapy.