BMJ  2003;327:1204 (22 November), doi:10.1136/bmj.327.7425.1204

Primary care

10-minute consultation

Recurrent urinary tract infection in women

¹ Department of Primary Health Care and General Practice, Imperial College of Science, Technology, and Medicine, London SW7 2AZ, ² Division of Community Health Services: GP Section, University of Edinburgh, Edinburgh EH10 5PF

The first 150 words of the full text of this article appear below.

Introduction

A 23 year old female student complains of urinary frequency and pain on micturition. She has had similar episodes on four other occasions in the last six months. She wants to know what can be done now and how to prevent further infections.

What issues you should cover

Is it really a urinary tract infection?—Differential diagnoses include common genital infections (such as sexually transmitted infections and Candida vulvovaginitis), non-infective cystitis (caused by nonsteroidal anti-inflammatory drugs and other drugs), and urethral syndrome (a complex of symptoms that indicate a urinary tract infection but without an underlying infection).

Type of urinary tract infection—Symptoms that indicate a lower urinary tract infection are discomfort on urination, increased frequency of urination, urgency, and a change in the smell of the urine. Symptoms that indicate an upper urinary tract infection are a high temperature, pain in the loin, nausea, vomiting, and rigors.

History—When was the last infection? Recurrent . . . [Full text of this article]

What you should do

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