From Awareness to Action: Women’s Self-Care Strategies and Clinical Behaviors in Recurrent Urinary Tract Infections

TL;DR

This study explores how women in Poland manage recurrent urinary tract infections, highlighting gaps in knowledge and inconsistent use of preventive care.

Contribution

The study provides insights into the real-world understanding and management of rUTI among women, emphasizing misalignment with clinical guidelines.

Findings

Only 36.1% of women correctly identified the definition of recurrent UTI.

Preventive care options like vaginal estrogen and non-antibiotic strategies were underused.

Fluoroquinolone antibiotics were commonly used despite guidelines advocating alternatives.

Abstract

Background and Objectives: Recurrent urinary tract infection (rUTI) remains common and burdensome, with growing emphasis on antibiotic stewardship and non-antibiotic prevention. We characterized what women with rUTI know, do, and receive in everyday care and identified gaps between patient understanding and guideline-concordant management. Materials and Methods: We conducted a single-center, cross-sectional survey of consecutive adult women presenting with rUTI to a urology clinic in Poland. A structured questionnaire captured demographics, knowledge, symptoms and triggers, diagnostics, treatments and prevention, and satisfaction. Responses were standardized a priori; descriptive statistics and exploratory comparisons were performed (N = 36). Results: The mean age was 53.0 years (SD: 14.8). Only 36.1% identified the correct rUTI definition, while 83.3% recognized bacteria as the common cause. The symptom profile was dominated by frequency and dysuria (each 88.9%); 27.8% reported intercourse as a precipitant, and this was more frequent among sexually active women (43.5% vs. 7.7%; p = 0.031). Over half (55.6%) perceived no seasonality. The median number of episodes in the prior year was five (IQR 4–6). Urine culture was obtained before treatment in 38.9% and after treatment in 13.9%. The overall satisfaction with care was low to moderate (13.9% were very satisfied, 61.1% were moderately satisfied, and 25.0% were dissatisfied). Prior antibiotic exposure included ciprofloxacin (55.6%), furazidin (75.0%), and fosfomycin (47.2%). The uptake of preventive options was uneven: immunoactive vaccines accounted for 19.4%, methenamine hippurate for 16.7%, pelvic floor physiotherapy for 33.3%, and vaginal estrogen for 5.6% overall (9.5% among women ≥ 50 years). Conclusions: In this clinic-referred cohort, rUTI was frequent and disruptive, factual knowledge was limited, urine culture use was inconsistent, and fluoroquinolone exposure remained common. Preventive care was misaligned with guidelines, with underuse of vaginal estrogen and variable adoption of non-antibiotic strategies. Targeted education, stewardship, and structured access to evidence-based prevention may improve outcomes.

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