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Recurrent urinary tract infection in women

BMJ 2003; 327 doi: (Published 20 November 2003) Cite this as: BMJ 2003;327:1204
  1. Josip Car (, doctoral student in patient-doctor partnerships1,
  2. Aziz Sheikh, professor of primary care research and development2
  1. 1Department of Primary Health Care and General Practice, Imperial College of Science, Technology, and Medicine, London SW7 2AZ
  2. 2Division of Community Health Services: GP Section, University of Edinburgh, Edinburgh EH10 5PF
  1. Correspondence to: J Car


    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 …

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