Recurrent urinary tract infections
Two or more infections in six months, or three in a year, deserve a closer look. The goal is to find the cause and stop the cycle, not just treat the next one.
Medically reviewed by Guillaume Farah, MD · Last reviewed October 2026
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Step 1 of 5
Your first visit
Within 24 to 48 hoursDr. Farah reviews your past urine cultures and antibiotics, asks about triggers, and checks how well your bladder empties.
What you do
Bring copies of past urine culture results if you have them.
Book a visitWhat Dr. Farah does
Looks for a cause, not just the next prescription.
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Step 2 of 5
Looking for a cause
Weeks 1 to 4Depending on your history, an ultrasound or CT scan and a quick look inside the bladder with a thin camera check for stones, blockages or other causes.
What you do
Most tests are done in the office or as outpatient imaging.
Book a visitWhat Dr. Farah does
Explains every result in plain words.
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Step 3 of 5
A prevention plan
OngoingDrinking more water and not holding urine help. After menopause, vaginal estrogen lowers the chance of infection. Some people do well with a low-dose preventive medicine, or with treating each infection quickly based on a urine culture.
What you do
Get a urine culture before starting antibiotics whenever you can.
Book a visitWhat Dr. Farah does
Builds a plan around your pattern of infections.
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Step 4 of 5
Fixing the cause
If one is foundWhen a kidney stone, an enlarged prostate or poor bladder emptying is driving the infections, treating it is often the lasting fix.
What you do
Ask which option fits your situation.
Book a visitWhat Dr. Farah does
Treats the underlying problem himself.
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Step 5 of 5
The data
Recurrent uncomplicated UTI in women (≥2 culture-proven infections in 6 months or ≥3 in 12 months) per the AUA/CUA/SUFU guideline: culture before treatment, vaginal estrogen for peri- and postmenopausal women, continuous or postcoital antibiotic prophylaxis, and non-antibiotic options such as methenamine hippurate. Complicated or male UTI warrants imaging and cystoscopy.
Each study link opens the newest results on PubMed.
- Recurrent uncomplicated UTIs in women: AUA/CUA/SUFU guideline (opens in new tab) Evaluation, prophylaxis and estrogen therapy
- Methenamine hippurate vs daily antibiotics for UTI prevention (ALTAR) (opens in new tab) Non-antibiotic prophylaxis
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