Information for health professionals
Chronic urinary tract infection (UTI) is a condition that requires more recognition in Australia. This webpage provides health professionals with an overview of the disease and includes links to detailed information on our website. Further down the page, there is a sign-up form for health professionals who wish to stay in touch and for doctors who are interested in the ‘Doctors Treating Chronic UTI’ group that convenes online quarterly to share information and discuss chronic UTI. We also provide downloadable PDF resources such as the Understanding Chronic UTI booklet, the Chronic UTI Worksheet, the UTI Factsheet and the Hearing Patient Voices chronic UTI survey report.
Stay in touch
Health professionals can keep up to date on chronic UTI and related matters by joining our contact list to receive information and updates as they become available.
If you are a general practitioner or a medical/surgical specialist, you can also indicate your interest in receiving more information about the ‘Doctors Treating Chronic UTI’ group. This group comprises Australian doctors with a shared interest in chronic UTIs. The group convenes online quarterly to exchange knowledge and discuss challenges related to the diagnosis and treatment of chronic UTI. Chronic UTI Australia facilitates the sessions, which run for 60-90 minutes and provide Continuing Professional Development certificates for attendees. The meetings aim to support doctors in broadening their understanding of the full spectrum of UTI, from acute to chronic, by engaging with both current scientific evidence and patient perspectives.
Chronic UTI in brief
What is chronic UTI?
Chronic UTI is characterised by persistent or fluctuating painful lower urinary tract symptoms that don’t respond to standard antibiotic treatment protocols and often goes undetected by regular UTI tests. Chronic UTI is caused by the parasitisation of bladder wall cells by intracellular microbes and microbial biofilms. Put simply, a chronic UTI is an embedded infection in the bladder or urinary tract. Read more here.
How to test for chronic UTI
Current UTI tests have limitations. For chronic UTIs, they may be too insensitive and unreliable to detect due to lower numbers of bacteria that invade the bladder lining and enter in and out of a dormant state. If the bacteria involved can grow outside the body on an agar plate, these lower-level bacterial loads will likely fall below the thresholds set for diagnosing acute UTI and may be interpreted as ‘negative’. You can read more about the limitations of UTI tests here.
Currently, the test for chronic UTI that is scientifically validated and considered reliable involves assessing the patient by taking a history, using a 39 point symptom score and detecting signs of infection in urine. This involves identifying white blood cells, red blood cells and epithelial cells through microscopy by examining an immediately fresh, unspun and unstained urine sample. The cell count is used primarily to generate a plot to monitor disease activity during treatment. Our Chronic UTI Worksheet helps guide doctors and patients through the assessment.
How to treat chronic UTI
There are currently no treatment guidelines for chronic UTI.
The only scientifically proven treatment for chronic UTIs involves continuous use of first-generation, narrow-spectrum antibiotics at full therapeutic doses over an extended period. This treatment was developed by Professor James Malone-Lee and his team at University College London (UCL) after decades of research. A study based on the treatment was published in 2018 titled Recalcitrant chronic bladder pain and and recurrent cystitis but negative urinalysis: What should we do?. Additionally, detailed information can be found in the 2021 book ‘Cystitis Unmasked’ (details further below).
You may be surprised that, in most cases, individuals in Australia are being treated for chronic UTI by a GP already known to them. Australia’s expertise in chronic UTI is limited, and many GPs are receiving guidance from international chronic UTI specialist clinics. You can read more about that here.
There are alternative treatments for chronic UTI that lack evidence-based support, which doctors and patients may attempt, although these often yield no or limited success. You can read about them on our treatment page. Other treatments available may temporarily relieve symptoms without addressing the underlying infection.
Who is Professor James Malone-Lee?
Professor Malone-Lee was renowned for his pioneering research into recurrent urinary tract infections (UTIs) and persistent lower urinary symptoms (LUTS) over nearly four decades. He established a busy NHS clinic associated with a thriving academic translational science unit at University College London (UCL), as well as a private clinic. Thousands of patients from across the United Kingdom and many other countries, including Australia, have received treatment at these specialist UTI clinics. Professor Malone-Lee passed away prematurely in January 2022. You can read more here and watch our 2021 Australian exclusive interview with him shown below.
Cystitis Unmasked
James Malone-Lee and his research group made findings that questioned several established views about lower urinary tract disease, especially infection. Initially, these findings faced rejection from many, but as supporting evidence emerged globally, this perspective has gained broader acceptance. You can read a detailed description of the book here. Cystitis Unmasked is available from online bookshops.
Chronic Urinary Infection Picture Commentary by Professor James Malone-Lee
This picture commentary by Professor Malone-Lee describes the formation of a chronic UTI. Each illustration is accompanied with detailed information describing the process. The picture commentary document is shared with permission from Professor Malone-Lee and can also be found in his 2021 book, Cystitis Unmasked (see above). Click here to download the PDF.
PDF downloads
Click on the PDFs to open/save to your device.
Understanding Chronic UTI booklet
The Understanding Chronic UTI booklet is desgined for individuals impacted by chronic UTI who are learning about the condition. It provides an introduction to problems with UTI tests and treatments, FAQs, important research articles and more. The 16-page booklet can be downloaded here.
Chronic UTI Worksheet
The Chronic UTI Worksheet is a tool designed to assist doctors and patients in managing chronic UTI. It offers a structured method for documenting symptoms, tracking pain and monitoring treatment, enhancing communication between patients and healthcare providers. The worksheet has been reviewed and edited by chronic UTI specialist Dr. Sheela Swamy, PhD MRCOG. The worksheet can be downloaded for use with chronic UTI patients. Click here for the PDF.
Hearing Patient Voices Report
The 2023 Hearing Patient Voices research project surveyed 410 individuals globally with chronic urinary tract infection (UTI). The online survey assessed the impact of chronic UTI on quality-of-life, concentrating on symptoms, various life domains, emotional wellbeing, healthcare experiences and avoidable expenses to the health system. The comprehensive report can be downloaded here.
UTI Factsheet
The UTI factsheet provides comprehensive information about acute, recurrent and chronic UTIs. It includes details on what a UTI is, the demographics most likely to experience one, common symptoms, how they are diagnosed, home treatment options, when to seek medical assistance, management of persistent UTIs, prevention strategies and future diagnostic and treatment methods. This factsheet can be downloaded and shared with individuals affected by UTIs or healthcare professionals who treat UTIs. Click here for the PDF.
UTI event flier for GPs (double sided)
The UTI flier is a quick reference desgined as an events handout or to print or save and share with anyone interested in chronic UTI. The front page highlights five key UTI facts that are not well known in Australia. The back describes chronic UTI and information about Chronic UTI Australia.
Click here to see the two page PDF in full and download
Visit Chronic UTI Australia’s new website
The Chronic UTI Australia website is the most current, comprehensive and well-researched source of chronic UTI information in Australia for both healthcare professionals and patients.
