Recurrent Urinary Tract Infections (UTIs)

Recurrent UTIs are common and can significantly disrupt daily life. They are defined as:

• Two infections within six months, or
• Three infections within one year

At RoMIUS Urology, we focus on identifying the true cause of repeated infections and providing long-term prevention strategies.

Causes of Recurrent UTIs

Recurrent infections may be related to:

• Bladder emptying issues
• Sexual activity
• Pelvic floor dysfunction
• Vaginal flora imbalance
• Bladder stones or anatomical concerns
• Post-menopausal changes
• Incomplete treatment of prior infections

Each case requires careful evaluation to determine the underlying cause.

Evaluation

Your assessment may include:

• Urinalysis and culture
• Bladder scan to assess emptying
• Cystoscopy when indicated
• Ultrasound or CT imaging (if needed)
• Pelvic examination
• Review of contributing factors such as hydration, bowel habits, and sexual health

We focus on accurate diagnosis to avoid unnecessary antibiotic use.

Treatment & Prevention

Treatment is individualized based on your specific situation and may include:

• Culture-directed antibiotics
• Short-term preventive antibiotic strategies (when appropriate)
• Hydration and lifestyle adjustments
• Pelvic floor physical therapy
• Supplements such as D-mannose or probiotics
• Addressing bladder emptying or anatomical issues
• Vaginal estrogen therapy for post-menopausal patients (when indicated)

Our goal is to break the cycle of repeated infections and improve long-term bladder health.

Perimenopause Symptoms

Perimenopause brings hormonal changes that can affect the urinary tract, vaginal tissue, pelvic floor, and overall comfort. These symptoms may occur with or without recurrent UTIs.

Common Symptoms

Women may experience:

• Vaginal dryness or irritation
• Painful intercourse
• Burning or sensitivity
• Bladder urgency or frequency
• Nighttime urination
• Mild bladder irritation
• Pelvic pressure
• Increased susceptibility to discomfort during urination

These symptoms are due to estrogen loss and changes in tissue elasticity, lubrication, and support.

Evaluation

Our evaluation is gentle and thorough and may include:

• Pelvic examination
• Discussion of sexual and hormonal history
• Assessment for vaginal atrophy
• Bladder function evaluation
• Review of urinary symptoms
• Consideration of pelvic floor dysfunction

This helps us determine the right treatment path for your needs.

Treatment Options

We offer a variety of therapies, including:

Hormonal Options

• Vaginal estrogen (cream, tablet, or ring)
• Low-dose, non-systemic therapy

These options help restore vaginal and urethral tissue health.

Non-Hormonal Options

• Vaginal moisturizers and lubricants
• Hyaluronic acid products
• Pelvic floor physical therapy
• Supplements
• Lifestyle modification

Bladder-Directed Treatments

For women with bladder-specific symptoms, treatment may include:

• Overactive bladder medications
• Bladder Botox
• Neuromodulation
• Bladder instillations

Why Women Choose RoMIUS Urology

• Dedicated expertise in women’s urinary and pelvic health
• Accurate, evidence-based evaluation
• Personalized treatment plans
• Options ranging from conservative care to minimally invasive treatments
• Focus on long-term comfort, confidence, and bladder health
• Collaborative care with pelvic floor therapy and gynecology when needed