Chronic UTI Symptoms

UTI symptoms are commonly dismissed as being a significant sign of infection when a urine test comes back negative.  However, some experts say symptoms are the best indicator of infection currently available.  Chronic UTI symptoms can include some (or all) of the symptoms expected during an acute UTI, along with other constant or intermittent pelvic and/or bladder symptoms. Typically, people with untreated chronic UTI will suffer these painful, relentless and often debilitating symptoms for many years or even entire lifetimes.

UTI symptoms

The following symptoms are based on patient data collected by leading global UTI expert, the late Professor Malone-Lee, from University College London.  Symptoms fall into four categories—pain, voiding, overactive bladder and urinary incontinence1.  You can have symptoms from all four categories, or just one.


Despite popular belief, you do not need to have burning/painful urination (dysuria) to have a UTI. This is considered a ‘classic’ acute UTI symptom.  However, dysuria is far less common with chronic UTI.


The Venn diagram further down is based on patients at the London clinic and shows the distribution of symptoms from the four different categories2.

  • Stress Urinary Incontinence

    • Cough/sneeze incontinence
    • Exercise incontinence
    • Laughing incontinence
    • Passive incontinence
    • Bending incontinence
    • Standing incontinenc

  • Voiding

    • Hesitancy
    • Reduced stream
    • Intermittent stream
    • Straining to void
    • Terminal dribbling
    • Post-void dribbling
    • Double voiding

  • Pain

    • Supra pubic pain
    • Filling bladder pain
    • Voiding bladder pain
    • Post-void bladder pain
    • Pain fully relieved by voiding
    • Pain unrelieved by voiding
    • Loin pain
    • Iliac Fossa pain
    • Pain radiating to genitals
    • Pain radiating to legs
    • Dysuria (painful urination)*
    • Urethral pain

  • Over Active Bladder

    • Urgency
    • Urgency incontinence
    • Latchkey urgency
    • Latchkey incontinence
    • Waking urgency
    • Waking incontinence
    • Running water urgency
    • Running water incontinence
    • Cold urgency
    • Anxiety urgency
    • Premenstrual aggravation

Symptoms triggers

Patients report common triggers that can bring on or increase their symptoms include:

  • sexual intercourse
  • internal gynaecological procedures
  • vigorous exercises such as horse riding and cycling
  • stress
  • bowel movements
  • alcohol
  • some foods that individuals are sensitive to.

Distribution of symptoms

1, 2 The symptoms list and Venn diagram is shared courtesy of the late Professor James Malone-Lee, Emeritus Professor of Nephrology, University College London, United Kingdom.  In addition to his involvement in chronic UTI research, Professor Malone-Lee headed a private clinic specialising in treating chronic bladder pain, chronic pelvic pain, recurrent urinary infection, voiding problems and overactive bladder symptoms. He specialised in this field of medicine for over three decades.   The need for chronic UTI diagnosis and treatment is sadly in demand, and increasing.  Now managed by his son, Dr Matthew Malone-Lee, the London clinic has been considered the world-leader in chronic UTI diagnosis and treatment, with patients from all over the world visiting the clinic.  You can find contact details for the clinic here. You can also look up Professor Malone-Lee’s 2019 book ‘Cystitis Unmasked’


Chronic UTI Patient Survey 2023


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