Chronic UTI Doctors

The most common enquiry we receive is: ‘Can you recommend a chronic UTI doctor in Australia?’. As a national advocacy organisation, we are unable to give treatment or practitioner recommendations. Unlike the United Kingdom, there are no chronic urinary tract infection (UTI) specialist clinics or doctors in Australia that we are currently aware of.

Despite a general lack of awareness and progress around acknowledging, recognising, diagnosing and treating chronic UTI in Australia, we know there are growing numbers of Australians being diagnosed and successfully treated for chronic UTI. The great news is, in most cases chronic UTI treatment is being provided by a general practitioner (GP) already known to the patient.

Please Note: The following information does not constitute recommendations by Chronic UTI Australia. In response to the questions we most frequently receive, we have complied and shared information gathered by other Australians in our community who have extensively researched their own treatment options.

How are people accessing chronic UTI treatment in Australia?

People in our community tell us that the most common chronic UTI diagnostic and treatment protocol being accessed in Australia is the scientifically validated chronic UTI treatment protocol developed and used in the United Kingdom at the LUTS Clinic at Whittington Hospital, London (headed by Dr Raj Khasriya) and the Chronic UTI Clinic in Harley Street, London (previously heading by Professor James Malone-Lee).

We are told that Australians can book a face-to-face (in person) or telephone/online video appointment with a doctor at the Harley Street Chronic UTI Clinic. A referral is not required for international patients. At the initial appointment the patient is assessed, diagnosed and, if required, a written treatment plan is provided by email to the patient’s nominated Australian GP. There is a private consultation fee which is not claimable from Medicare or Australian private health insurers. GPs can contact the London Chronic UTI Clinic direct with questions or to request additional information, free of charge. If agreeable, the patient’s Australian GP will write prescriptions and request other tests that might be required throughout the treatment period. On becoming a patient of the Harley Street clinic, people can access the email service to report a deterioration in symptoms or side effects etc. The patient email service incurs a fee.

A small number of Australians have told us they are receiving chronic UTI treatment from Dr Stewart Bundrick in the United States. They tell us they book appointments through Dr Bundrick’s clinic and consult with him over an online video appointment. Dr Bundrick requests that new patients send a urine sample to an American DNA testing clinic of his choice before the first appointment, and possibly at various stages throughout the treatment depending on treatment response and progress. There are significant costs associated with DNA testing (which could require multiple tests) and serious concerns around the validity of the test results in relation to diagnosing chronic UTI and directing treatment*.

Patients consulting with Dr Bundrick have told us they access their medication through a local prescribing GP supporting their treatment.

As stated above, this information is provided to help with your own research. We cannot stress enough that it is important to continue researching your options by reading information and talking to others in the chronic UTI community who are undergoing treatment or researching their treatment options. We share more information on how to connect with the global chronic UTI community further below.

*There is no evidence or consensus in the scientific community on the accuracy of DNA-based molecular testing to diagnose chronic UTI. Some leading UTI researchers do not support the use of DNA-based molecular testing to diagnose chronic UTI or direct treatment due to the current lack of understanding of the urinary microbiome and the inability to conclusively identify and describe the microbes responsible for health and disease. We do accept that people improve under the care of practitioners who employ DNA testing to help guide treatment. Therefore, it may be best used by experienced practitioners in conjunction with the patient’s history, symptoms and other tests.

How do doctors access the chronic UTI treatment protocol used in the United Kingdom?

We are aware of an increasing number of Australian GPs prescribing treatment according to the scientifically backed chronic UTI protocol developed in the United Kingdom. However, people tell us that before approaching a doctor it has been necessary to gain a good understanding of chronic UTI from the information on our website and by talking to others in the online support groups. Most say they have found it helpful to print out relevant information to share and discuss with their GP. Many have told us that finding the right GP to treat them is critical and for some it has been the hardest part of their journey. Some patients say they have seen multiple GPs before finding one who was interested in chronic UTI and willing to help. Others have told us the good relationship they have with an existing GP has made it much easier to have the necessary discussions about chronic UTI treatment.

Once a GP has agreed to help with the new treatment, the GP can email the Chronic UTI Clinic in London to request the diagnostic and treatment protocol for chronic UTI.

Alternatively, we are told that when a patient has already consulted with a UTI doctor at the Harley Street Chronic UTI Clinic (either in person or via an online video consultation) an email will be sent to the patient’s nominated GP—this is packed full of information about the condition and the treatment protocol. Australian GPs are welcome to email the clinic with questions about the treatment—this will not incur a cost to the GP or the patient.

How does the treatment process work in Australia?

Medication Prescriptions

People in the chronic UTI community tell us that after a diagnosis has been made—either through an Australian GP who is familiar with the chronic UTI treatment protocol used in the United Kingdom or after having a consultation with a doctor at the Harley Street Chronic UTI Clinic—the local GP will prescribe the antimicrobial treatment. This generally involves a protracted course of full-dose, first generation, narrow spectrum antibiotics in conjunction with Hiprex (methenamine hippurate). In some cases, people have been prescribed Hiprex alone. Treatment for chronic UTI takes a long time (the LUTS Clinic says the average duration of treatment is 383 days), so people have said a follow-up appointment is booked for around 8-12 weeks, unless there are adverse side effects or a deterioration in symptoms. Treatment continues and is carefully monitored until symptoms and urinary signals fully resolve. You can read more about the treatment at the NHS LUTS Clinic in London, which is the same treatment offered at the private Harley Street Chronic UTI Clinic.

Immediate Urine Microscopy

The chronic UTI protocol plots the progress of treatment by monitoring symptom improvement and traditionally ignored—but extremely important—signals in the urine (white blood cells and epithelial cells) using immediate urine microscopy. Although this is a basic microscopy procedure well within the capabilities of most pathology labs, it is often difficult to request in Australia. People tell us they have found independent labs or private medical scientists, in various Australian states and territories, happy to conduct this service. The best way to find out more information is by talking to others in the online support group/s specific to Australian/New Zealander members.

How do people access the medication needed to treat chronic UTI?

As explained above, people following the chronic UTI treatment protocol developed in the United Kingdom tell us that the antimicrobials prescribed are mostly first generation, narrow spectrum antibiotics commonly used in Australia. The medication recommendation is made by following the listings in the treatment protocol or as advised by the United Kingdom chronic UTI doctors and prescribed by the Australian doctor.

We are told there have been occasions where an antibiotic chosen for specific reasons cannot be accessed in Australia. In these instances, patients have said they were able to import the necessary medication through the Therapeutic Goods Administration (TGA) Personal Importation Scheme, as long as a prescription written by an Australian-registered doctor accompanies the incoming medication. The Personal Importation Scheme allows an individual to import a three-month supply at one time but no more than a 15-month supply over a 12-month period. The TGA website states that to import more than a three-month supply at one time, an Australian-registered doctor must apply to the TGA for approval to the Special Access Scheme. Please see the TGA website for more information explaining the rules for both schemes.

We have also been told by people in our community that an Australian compounding pharmacy has imported ingredients to make up an antibiotic that is not readily available in Australia. As with any antibiotic, a prescription from an Australian-registered doctor is required.

Why do Australians have to research their own diagnosis and treatment?

Unfortunately, chronic UTI is not well recognised in Australia. In contrast to the United Kingdom, there are no chronic UTI specialist clinics in Australia. It is unlikely Australian doctors will consider chronic UTI as a possible cause for those with ongoing lower urinary tract symptoms (LUTS) who return negative results on mid-stream urine (MSU) cultures and urinary dipsticks. Despite our advocacy efforts, very little large-scale awareness has been achieved and there has been a reluctance by relevant Australian organisations to join us in advocating for a change in the current diagnostic and treatment guidelines for UTI.

This means you will most likely need to educate your own doctor about chronic UTI and the problems with exiting UTI testing and treatment. A great way of doing this is to share information from our website and by sharing a copy of Emeritus Professor James Malone-Lee’s 2020 book ‘Cystitis Unmasked’.

How to find information and support

In addition to reading the information on our website, there are several well-run online support groups where you can talk to others who are receiving treatment, have successfully completed treatment or are still researching their treatment options. The good quality groups are independent with no commercial influence or alliances and are run by patients, for patients. The quality groups we are aware of are Facebook groups, so you will need a Facebook account to join. Please be aware that, like our organisation, the administrators of these groups cannot give medical advice and they are not able to make treatment or practitioner recommendations. The role they have assumed is to provide a safe, private and organised space where patients can talk with one another and share personal experiences.

Australians have told us the groups they benefit from the most are (December 2021):

Chronic and Recurrent UTI Support Group (Australia and New Zealand)

This is a private group that accepts residents of Australia and New Zealand only. This group focuses on science-based discussions about treatment for chronic UTI with a strong emphasis on exploring solutions to overcome our geographical challenges in seeking treatment. The group is for women, men and parents/carers of children with chronic UTI.

Embedded/Chronic UTI Support Group

This is a very large private group that is UK-based with many international members. This group focuses on science-based discussions about treatment for chronic UTI and is for women and men.

More information

You are welcome to contact us if you feel you need more information, but please be aware we are legally unable to provide practitioner recommendations or medical advice.

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