Table 2.

Indications for further investigation of recurrent urinary tract infection

Prior urinary tract surgery or trauma

Gross hematuria after resolution of infection

Previous bladder or renal calculi

Obstructive symptoms (straining, weak stream, intermittency, hesitancy), low uroflowmetry or high PVR

Urea-splitting bacteria on culture (e.g., Proteus, Yersinia)

Bacterial persistence after sensitivity-based therapy

Prior abdominopelvic malignancy

Diabetes or otherwise immunocompromised

Pneumaturia, fecaluria, anaerobic bacteria or a history of diverticulitis

Repeated pyelonephritis (fevers, chills, vomiting, CVA tenderness)

Asymptomic microhematuria after resolution of infection should be evaluated as per CUA guidelines25

PVR: post-void residual CVA: costovertebral angle; CUA: Canadian Urological Association.