I was teaching medical students recently when one of the woman students asked me about how someone who was having multiple urinary infections should be treated and what might be causing them. I told her that there could be several causes, but since she indicated that her friend was sexually active that was the most likely cause. Other causes could be lack of good hygiene on her part or her partner's, congenital or birth abnormalities. As women get older they often can't completely empty their bladder which makes it easy for infection to occur. Constipation can also be association with repeated urinary infections.
Unfortunately far too many women have repeated bladder infections without seeking medical advice. If a woman is sexually active, it is important that she emply her bladder before going to sleep. For on-going problems an antibiotic, such as a sulfa drug, may be prescribed at bedtime. There are multiple other drugs that might be used. Anyone with several bladder infections should be seen a board-certified urologist and a good work-up done. This means taking a history and doing a good examination of the bladder. In addition, other studies may need to be done to look at the kidneys, the tubes connecting the kidneys to the bladder (ureters) and the urethra or the tube from the bladder to the outside. A urinalysis and urine culture should always be done to look for infection or other abnormalities.
If a little boy has one bladder infection then a pediatric urologist should be consulted. With little girls usually a urologist should be seen after at least two infections since small girls often don't clean themselves adequately after a bowel movement. It is very important that bladder infections don't start reaching the kidneys and cause infection or pyelonephritis. This can result in a high fever and be quite serious.