The impact of recurrent urinary tract infections in women: a qualitative study

Background Although many women experience recurrent urinary tract infections (rUTI), their significance for affected women is poorly described and understood. Aim We aimed to explore women’s experiences of rUTI and its impact on their lives. Design and Setting A qualitative study embedded in a UK randomised controlled trial (RCT) of D-mannose with women with clinically defined rUTI. Method We conducted semi-structured telephone interviews with 32 women who participated in the RCT. Interviews were audio-recorded and transcribed verbatim. Data were analysed thematically. Results Women reported how the experience of rUTI was burdensome with distressing and debilitating physical symptoms and wider disruptive effects. Women expressed how rUTI had impacted different stages of their lives and we identified two types of impact. Internalised impact included the women’s emotional response to rUTI, dread of a recurrence and maintaining readiness to manage it. Externalised impact encompassed actions in response to rUTI, including remaining extremely vigilant about recurrences and seeking help as soon as a recurrence was suspected, and the challenges they faced. The women explained how the responses of Health Care Professionals (HCPs) when they sought care affected their help-seeking and their self-esteem, and could leave them feeling a sense of helplessness. Conclusion Experience of rUTI has taught women to be vigilant and proactive about the condition but this was not always matched with understanding and validation on the part of HCPs. When women experiencing rUTI seek care, clinicians could usefully consider their broader experience of rUTI, including internalised and externalised impacts.