Advice: Single, uncomplicated UTIs do not need referral. If systemic symptoms are present, or infection is recurrent or recurring, please refer for assessment.
Refer To: Urologist
UTI in post-menopausal women
Uncomplicated UTIS are common in post-menopausal women. Please ensure a mid-stream MCS is sent off before treating with antibiotics. Recurrent or recurring UTIs are a difficult and common problem. Very often, symptoms are present without evidence of infection, making management difficult. Please refer if your patient is at a stage. It is very helpful to have a record of documented UTIs and sensitivities sent with the patient.
Microscopic haematuria is common in the presence of UTI. In any woman over 50, or woman <50 yrs with risk factors for bladder cancer, please repeat a dipstick when UTI has been treated. If still present, please refer for microscopic haematuria (see link). The main risk factor for bladder cancer is a history of smoking, but exposure to industrial chemicals should also be considered.
UTI in younger women
It is common for younger, sexual active women to go through periods of recurrent UTI, which can be problematic. Again, if infrequent and uncomplicated (no systemic symptoms, no underlying abnormalities), these are best treated as they occur, guided by MC&S of urine.
If recurrent and problematic, please refer. Options that can be discussed include:
- Long course of cycle antibiotics
- Post-coital antibiotics
Referral is needed for any UTI in women with the following problems:
UTI associated with stones, or urinary tract obstruction (urgent referral)
Signs or symptoms of systemic infection (urgent referral)
Patients with neurological problems
Complex medical history
Previous urological surgery
Transplant or other immunosuppressed patients.