Infección urinaria recurrente en la mujer

Recurrent urinary tract infection (R-UTI) in women is a very common phenomenon that increases with age. It generally occurs in patients without alterations of the urinary tract, so that contrasted imaging, endoscopic and / or functional tests of the urinary tract should be reserved for selected cases. 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, maternal history of UTI and recent use of antimicrobials drugs. No association has been found between uncomplicated R-UTI and renal scars, hypertension or progressive chronic kidney disease. Among the therapies for the prevention of recurrence of proven effectiveness are continuous and postcoital antimicrobial prophylaxis, oral vaccine and vaginal estrogen replacement in postmenopausal women, with antimicrobial prophylaxis showing the best results. The collateral damage caused by antimicrobial therapy should always be taken into account. The use of vaginal vaccine and vaginal lactobacilli are in development and its results are promising. The use of cranberries and ascorbic acid have not proven their effectiveness. Finally, R-UTI can also be effectively managed with self-start antimicrobial therapy in women with good adherence to medical indications.