{"id":1488,"date":"2020-08-14T08:00:00","date_gmt":"2020-08-14T01:00:00","guid":{"rendered":"https:\/\/drsoaraweeurology.com\/?p=1488"},"modified":"2026-08-15T00:21:24","modified_gmt":"2026-08-14T17:21:24","slug":"wiederkehrende-blasenentzundung","status":"publish","type":"post","link":"https:\/\/drsoaraweeurology.com\/de\/2020\/08\/14\/recurrent-bladder-infection\/","title":{"rendered":"Why Does My Bladder Infection Keep Coming Back?"},"content":{"rendered":"\n<div class=\"wp-block-columns coblocks-author-columns has-background is-layout-flex wp-container-core-columns-is-layout-52275889 wp-block-columns-is-layout-flex\" style=\"background-color:#8C8C971A;padding-top:2.5rem;padding-right:2.5rem;padding-bottom:2.5rem;padding-left:2.5rem\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:25%\">\n<figure class=\"wp-block-image size-full is-style-rounded\"><img data-recalc-dims=\"1\" fetchpriority=\"high\" decoding=\"async\" width=\"800\" height=\"800\" data-attachment-id=\"7037\" data-permalink=\"https:\/\/drsoaraweeurology.com\/de\/new-photo-2024\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2023\/12\/New-Photo-2024.png?fit=800%2C800&amp;ssl=1\" data-orig-size=\"800,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Dr. Soarawee Weerasopone \u2014 Board-Certified Urologist in Bangkok, Thailand\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Dr. Soarawee Weerasopone \u2014 Board-Certified Urologist in Bangkok, Thailand&lt;\/p&gt;\n\" 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0-2.016-1.284-3.722-4.097-3.722h-2.222z\"\/>\n    <\/svg>\n  <\/a>\n  \n  <a href=\"https:\/\/scholar.google.com\/citations?user=lTgsRMUAAAAJ&#038;hl=en\" \n     target=\"_blank\" \n     rel=\"noopener\"\n     title=\"Google Scholar\"\n     aria-label=\"View Google Scholar Profile\"\n     style=\"text-decoration: none; color: #4285F4; transition: transform 0.2s; display: inline-block;\"\n     onmouseover=\"this.style.transform='scale(1.15)'\"\n     onmouseout=\"this.style.transform='scale(1)'\">\n    <svg width=\"28\" height=\"28\" viewBox=\"0 0 24 24\" fill=\"currentColor\">\n      <path d=\"M5.242 13.769L0.5 9.5 12 1l11.5 8.5-4.742 4.269C17.548 11.249 14.978 9.5 12 9.5c-2.977 0-5.548 1.748-6.758 4.269zM12 10a7 7 0 1 0 0 14 7 7 0 0 0 0-14z\"\/>\n    <\/svg>\n  <\/a>\n  \n<\/div>\n\n\n\n<p class=\"has-drop-cap wp-block-paragraph\">I have written previously about the first episode of a bladder infection \u2014 <a href=\"https:\/\/drsoaraweeurology.com\/2020\/07\/11\/bladder-infection-acute-cystitis\/\">acute cystitis<\/a>. This article is about what happens when it will not stop coming back, even after every course of antibiotics has been taken properly and in full. That pattern has its own name: <strong>recurrent cystitis<\/strong>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The definition is worth knowing, because it is the threshold at which the problem stops being a run of bad luck and starts being something to investigate: <strong>two or more episodes within 6 months, or three or more within a year<\/strong>. It is reported in over 30% of women who have had a bladder infection. It is not life-threatening, but it takes a real toll on daily life.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"533\" data-attachment-id=\"1499\" data-permalink=\"https:\/\/drsoaraweeurology.com\/de\/2020\/08\/14\/recurrent-bladder-infection\/vaginal-or-urinary-infection-and-problems-concept-young-woman-holds-paper-with-help-above-crotch\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/08\/Women-bladder-help.jpg?fit=1200%2C800&amp;ssl=1\" data-orig-size=\"1200,800\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;2&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;Canon EOS 5D Mark II&quot;,&quot;caption&quot;:&quot;Vaginal or urinary infection and problems concept. Young woman holds paper with HELP above crotch.&quot;,&quot;created_timestamp&quot;:&quot;1518097076&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;135&quot;,&quot;iso&quot;:&quot;250&quot;,&quot;shutter_speed&quot;:&quot;0.005&quot;,&quot;title&quot;:&quot;Vaginal or urinary infection and problems concept. Young woman holds paper with HELP above crotch&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Recurrent Bladder infection severely affect quality of life\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Recurrent Bladder infection severely affect quality of life&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/08\/Women-bladder-help.jpg?fit=800%2C534&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/08\/Women-bladder-help.jpg?resize=800%2C533&#038;ssl=1\" alt=\"A woman affected by repeated bladder infections\" class=\"wp-image-1499\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/08\/Women-bladder-help.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/08\/Women-bladder-help.jpg?resize=300%2C200&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/08\/Women-bladder-help.jpg?resize=1024%2C683&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/08\/Women-bladder-help.jpg?resize=768%2C512&amp;ssl=1 768w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Recurrent bladder infection takes a serious toll on quality of life.<\/figcaption><\/figure>\n\n\n\n<h4 class=\"wp-block-heading\">Why it comes back: two <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/28974905\/\">accepted mechanisms<\/a><\/h4>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>The bacteria themselves.<\/strong> <em>Escherichia coli<\/em> causes most cases, and certain strains have a particular trick: they attach to the vaginal lining and hide <em>inside<\/em> the cells of the bladder wall while the antibiotic is being taken, then emerge once the course is finished and start a new infection. This is the single best explanation for the pattern patients find so baffling \u2014 getting better on treatment, then relapsing a few weeks later.<\/li>\n\n\n\n<li><strong>The host.<\/strong> Reduced immunity makes reinfection easier, more frequent and more severe. Keeping general health up and any chronic condition well controlled genuinely matters here \u2014 diabetes in particular.<\/li>\n<\/ol>\n\n\n\n<figure class=\"wp-block-image aligncenter size-large\"><img data-recalc-dims=\"1\" decoding=\"async\" width=\"800\" height=\"695\" data-attachment-id=\"1500\" data-permalink=\"https:\/\/drsoaraweeurology.com\/de\/2020\/08\/14\/recurrent-bladder-infection\/man-in-underpants-holds-inscription-help-isolated-on-white-background\/\" data-orig-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/08\/Men-bladder-help.jpg?fit=1200%2C1043&amp;ssl=1\" data-orig-size=\"1200,1043\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;14&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;Canon EOS 5D Mark IV&quot;,&quot;caption&quot;:&quot;Man in underpants holds inscription Help, isolated on white background&quot;,&quot;created_timestamp&quot;:&quot;1584718282&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;70&quot;,&quot;iso&quot;:&quot;200&quot;,&quot;shutter_speed&quot;:&quot;0.00625&quot;,&quot;title&quot;:&quot;Man in underpants holds inscription Help, isolated on white background&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Men are also sometimes complaint Recurrent bladder infection issue\" data-image-description=\"\" data-image-caption=\"&lt;p&gt;Men are also sometimes complaint Recurrent bladder infection issue&lt;\/p&gt;\n\" data-large-file=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/08\/Men-bladder-help.jpg?fit=800%2C695&amp;ssl=1\" src=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/08\/Men-bladder-help.jpg?resize=800%2C695&#038;ssl=1\" alt=\"A man with a urinary tract infection, which always warrants investigation\" class=\"wp-image-1500\" srcset=\"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/08\/Men-bladder-help.jpg?w=1200&amp;ssl=1 1200w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/08\/Men-bladder-help.jpg?resize=300%2C261&amp;ssl=1 300w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/08\/Men-bladder-help.jpg?resize=1024%2C890&amp;ssl=1 1024w, https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2020\/08\/Men-bladder-help.jpg?resize=768%2C668&amp;ssl=1 768w\" sizes=\"(max-width: 800px) 100vw, 800px\" \/><figcaption class=\"wp-element-caption\">Recurrent infection in a man is less common and always needs investigating.<\/figcaption><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">One point about men, since most of what is written on this subject is addressed to women. A urinary tract infection in a man is much less common, and it is never assumed to be simply bad luck: it warrants assessment of the prostate, of how well the bladder empties and of the upper urinary tract, even after a single episode.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">What a proper workup looks for<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Beyond those two mechanisms, there are several contributing factors that can be identified and dealt with \u2014 and this is precisely the value of seeing a urologist rather than taking another antibiotic course.<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>Behavioural factors<\/strong> \u2014 frequency of sexual activity, multiple partners and certain vaginal products all raise the risk, particularly in younger women. One simple, evidence-supported habit: <strong>pass urine once, soon after intercourse<\/strong>, which flushes bacteria out of the urethra before they can travel up to the bladder.<\/li>\n\n\n\n<li><strong>Anatomy of the urinary tract<\/strong> \u2014 imaging can reveal correctable causes such as kidney stones or obstruction. A stone can harbour bacteria indefinitely, which is why no course of antibiotics ever fully clears the infection until the stone is dealt with.<\/li>\n\n\n\n<li><strong>Residual urine<\/strong> \u2014 a bladder that does not empty completely leaves a standing pool for bacteria to multiply in. Measuring it is quick and non-invasive, and it changes the management entirely when it is found.<\/li>\n\n\n\n<li><strong>Hormonal factors<\/strong> \u2014 after the menopause, falling estrogen depletes the vaginal Lactobacilli that normally keep E. coli at bay. Topical vaginal estrogen restores that protective flora and is one of the more effective measures available in this group.<\/li>\n<\/ol>\n\n\n\n<p class=\"wp-block-paragraph\">One practical addition to that list: <strong>ask for a urine culture while you still have symptoms<\/strong>, before the next antibiotic is started. Repeated courses given without ever identifying the organism are how resistant strains develop, and they also make it impossible to tell a genuine reinfection from a symptom that was never bacterial in the first place.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The reason this list matters is that three of the four are things no amount of antibiotics will fix. If your infections keep returning, the useful question is not which antibiotic to try next but <strong>what is being missed<\/strong> \u2014 and that is what a proper evaluation is for.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>While you are waiting for that evaluation, some symptoms should not wait at all.<\/strong> Fever with pain in the flank or back, shaking chills, nausea and vomiting, or feeling very unwell suggest the infection has reached the kidney and need same-day medical care. So do visible blood in the urine, an infection during pregnancy, and symptoms that fail to settle within 48 hours of starting an antibiotic.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Once any correctable cause has been dealt with, there are also several <a href=\"https:\/\/drsoaraweeurology.com\/2020\/09\/20\/3-step-prevent-bladder-infection\/\">non-antibiotic ways to reduce recurrence<\/a>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If you have been suffering from recurrent bladder infections and would like a comprehensive evaluation and personalized prevention plan, Dr. Soarawee Weerasopone offers specialist consultations at Bangkok Hospital Headquarters. <a href=\"https:\/\/www.bangkokhospital.com\/en\/bangkok\/doctor\/dr-soarawee-weerasopone-2\">Book a Consultation<\/a>. Appointments at Samitivej Sriracha Hospital can be arranged by calling the Urology department on <a href=\"tel:0880221445\">088-022-1445<\/a>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Bangkok Hospital also runs a Telemedicine service, which is a reasonable way to review your pattern of infections and past culture results and to plan what needs testing \u2014 the imaging, the bladder-emptying measurement and the cultures themselves are then arranged in person. Arrange it in advance by email to the Urology department at <a href=\"mailto:bhquro@bdms.co.th\">bhquro@bdms.co.th<\/a>. Samitivej Sriracha is in-person only. An infection you have right now, particularly with fever, needs to be seen rather than discussed by video.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Frequently Asked Questions about Recurrent Bladder Infection<\/h2>\n\n\n\n<div class=\"schema-faq wp-block-yoast-faq-block\"><div class=\"schema-faq-section\" id=\"faq-question-1\"><strong class=\"schema-faq-question\">What is recurrent cystitis?<\/strong> <p class=\"schema-faq-answer\">Recurrent cystitis is defined as two or more bladder infection episodes within 6 months, or three or more episodes within a single year, despite completing appropriate antibiotic treatment. It affects more than 30% of women who have had an initial bladder infection and significantly impacts daily quality of life, though it is not life-threatening.<\/p><\/div> <div class=\"schema-faq-section\" id=\"faq-question-2\"><strong class=\"schema-faq-question\">Why does my bladder infection keep coming back even after antibiotics?<\/strong> <p class=\"schema-faq-answer\">Some strains of E. coli have a unique survival strategy &#8211; they attach to vaginal mucosal cells and hide within bladder lining cells during antibiotic treatment, then re-emerge once the antibiotic course ends. This bacterial persistence mechanism is a primary reason why infections recur even after seemingly successful treatment. Contributing factors such as stones, incomplete bladder emptying or estrogen deficiency also need excluding.<\/p><\/div> <div class=\"schema-faq-section\" id=\"faq-question-3\"><strong class=\"schema-faq-question\">Does sexual activity cause recurrent bladder infections?<\/strong> <p class=\"schema-faq-answer\">Yes, sexual activity is a well-established risk factor for recurrent UTI in women. Frequency of intercourse, multiple partners, and use of spermicides all increase risk. A simple and effective preventive measure is to urinate once immediately after sexual intercourse, which helps flush bacteria from the urethra before they can ascend to the bladder.<\/p><\/div> <div class=\"schema-faq-section\" id=\"faq-question-4\"><strong class=\"schema-faq-question\">Can menopause cause recurrent bladder infections?<\/strong> <p class=\"schema-faq-answer\">Yes. After menopause, declining estrogen levels reduce the natural Lactobacilli population in the vagina. These beneficial bacteria normally form a protective barrier against E. coli invasion. Loss of this flora increases bladder infection susceptibility. Intravaginal topical estrogen cream is an evidence-supported treatment to restore vaginal flora and reduce recurrence in postmenopausal women.<\/p><\/div> <div class=\"schema-faq-section\" id=\"faq-question-5\"><strong class=\"schema-faq-question\">When should I see a urologist for recurrent bladder infections?<\/strong> <p class=\"schema-faq-answer\">You should consult a urologist if you experience 2 or more bladder infections within 6 months, or 3 or more in a year. A urologist will perform a comprehensive workup including imaging to rule out kidney stones, urinary obstruction, or residual urine, and will develop an individualized prevention strategy that may include non-antibiotic supplements, hormonal therapy, or long-term prophylaxis. A urinary tract infection in a man is investigated even after a single episode.<\/p><\/div> <div class=\"schema-faq-section\" id=\"faq-question-6\"><strong class=\"schema-faq-question\">Which symptoms mean I should be seen the same day?<\/strong> <p class=\"schema-faq-answer\">Fever with flank or back pain, shaking chills, nausea and vomiting, or feeling very unwell suggest the infection has reached the kidney and need same-day care. Visible blood in the urine, infection during pregnancy, and symptoms that do not settle within 48 hours of starting an antibiotic also need prompt review rather than waiting for a routine appointment.<\/p><\/div><\/div>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Disclaimer:<\/strong> This content is written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters. It is intended for educational purposes only and does not constitute medical advice. Fever with flank pain needs same-day medical assessment. No medical advice, diagnosis or prescription is provided through personal messaging channels. Always consult a qualified healthcare professional before starting any medical treatment.<\/p>\n\n\n\n<script type=\"application\/ld+json\">\n{\n  \"@context\": \"https:\/\/schema.org\",\n  \"@graph\": [\n    {\n      \"@type\": \"MedicalWebPage\",\n      \"@id\": \"https:\/\/drsoaraweeurology.com\/2020\/08\/14\/recurrent-bladder-infection\/#medicalwebpage\",\n      \"url\": \"https:\/\/drsoaraweeurology.com\/2020\/08\/14\/recurrent-bladder-infection\/\",\n      \"name\": \"Why Does My Bladder Infection Keep Coming Back?\",\n      \"headline\": \"Why Does My Bladder Infection Keep Coming Back?\",\n      \"description\": \"Recurrent cystitis \u2014 two or more episodes in six months or three in a year \u2014 has two accepted mechanisms and four contributing factors that a proper workup can identify. 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Dr. Soarawee explains the 2 core mechanisms and 4 modifiable risk factors behind recurrent UTI in women \u2014 and how to stop the cycle.","jetpack_seo_html_title":"Recurrent Bladder Infection in Women: Causes & How to Stop It | Dr. Soarawee Urology","jetpack_seo_noindex":false,"jetpack_seo_schema_type":"","_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_wpcom_ai_launchpad_first_post":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"{title}\n\n{excerpt}\n\n{url}","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"_wpas_customize_per_network":false,"jetpack_post_was_ever_published":false},"categories":[1362],"tags":[1482,1473,1483],"class_list":["post-1488","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-infection","tag-bladder-infection","tag-chronic-bladder-infection","tag-chronic-cystitis"],"jetpack_publicize_connections":[],"jetpack_likes_enabled":false,"jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/pgZdrK-o0","jetpack_featured_media_url":"https:\/\/i0.wp.com\/drsoaraweeurology.com\/wp-content\/uploads\/2026\/04\/Recurrent-UTI.webp?fit=1200%2C630&ssl=1","_links":{"self":[{"href":"https:\/\/drsoaraweeurology.com\/de\/wp-json\/wp\/v2\/posts\/1488","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drsoaraweeurology.com\/de\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drsoaraweeurology.com\/de\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/de\/wp-json\/wp\/v2\/users\/185281453"}],"replies":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/de\/wp-json\/wp\/v2\/comments?post=1488"}],"version-history":[{"count":28,"href":"https:\/\/drsoaraweeurology.com\/de\/wp-json\/wp\/v2\/posts\/1488\/revisions"}],"predecessor-version":[{"id":11436,"href":"https:\/\/drsoaraweeurology.com\/de\/wp-json\/wp\/v2\/posts\/1488\/revisions\/11436"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/de\/wp-json\/wp\/v2\/media\/10088"}],"wp:attachment":[{"href":"https:\/\/drsoaraweeurology.com\/de\/wp-json\/wp\/v2\/media?parent=1488"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/de\/wp-json\/wp\/v2\/categories?post=1488"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drsoaraweeurology.com\/de\/wp-json\/wp\/v2\/tags?post=1488"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}