Doctors demand chronic UTI strategy with up to four million sufferers in UK

Doctors have called for an official strategy for diagnosing and treating chronic urinary tract infections (UTIs) as fresh estimates show there could be four million sufferers in the UK.

During the last government, the NHS formally recognised the condition on its website, and treatment guidelines for UTIs were changed, recognising that some current tests and techniques are outdated.

However, there is still only one NHS treatment centre in London – the Lower Urinary Tract Symptoms (Luts) Service at the Whittington Hospital – and the waiting list is more than a year long.

Dr Rajvinder Khasriya, an NHS consultant urogynaecologist at the specialist clinic, called for an urgent “strategy for management” to help doctors diagnose and treat patients in the interim while new tests and treatment options are developed.

Specialists say the infections, which often begin as an acute bout of cystitis, can occur when bacteria become embedded within the bladder wall and become difficult to treat with short courses of antibiotics.

The illness commonly affects women and can leave them unable to work, sleep, go out of the house or socialise with friends and family, and in some cases can even lead to people feeling suicidal.

Dr Khasriya told i: “Whilst we now acknowledge and accept that the diagnostics for UTI are not great, we need some sort of strategy for management while we try and sort out a new diagnostic.

“It may take 10 years or so to validate something. In the meantime, we need to lift any moratorium on how we treat these patients.

“We need to allow certain centres to be able to treat these patients who have tried everything else. We need to be allowed to practise all of that safely in the NHS with the correct governance knowing that the tests are not good.”

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Dr Khasriya said chronic UTI affects approximately four million women in the UK.

This is based on estimates that around half of all UK women have had a UTI, and around 30 per cent of these become recurrent or chronic.

With the condition affecting so many women across the country, Dr Khasriya urged a new government to fund and develop nationwide “provision of care”.

She said: “We need treatments in all areas of the UK. A lot of women are having to come to specialist centres like the Whittington and that’s in London. Really, we need provision everywhere.”

The vice-president of the Royal College of Obstetricians and Gynaecologists (RCOG), Hassan Shehata, called on a new government to include chronic UTI in the women’s health strategy.

The Department for Health and Social Care (DHSC) introduced the 129-page strategy in July 2022, meaning it will enter its third year this summer.

The strategy addresses the “male as default” approach to healthcare in medical research, training for healthcare professionals, and the design of health politics and services.

The strategy – designed to understand the changing health and care needs of women and girls across their lives – has created women’s health hubs, made HRT more accessible and made a dedicated area for women and girls on the NHS website.

But chronic UTI has not been included in the strategy, despite calls from doctors and campaigners.

Dr Shehata said the condition has “serious co-morbidities and long-term complications” and a “life course negative impact on women’s health”.

Asked if chronic UTI should be included, he said: “Why not? It is a problem that will have a life course negative impact on women’s health.”

CUTIC, the chronic UTI campaign group, called on a new health minister to “take notice of this serious health condition and enter into discussions with the relevant organisations and specialist chronic UTI doctors”.

A spokesperson said: “CUTIC ideally wants to see the Women’s Health Strategy specifically include Chronic UTI and champion the need for a specific diagnostic and treatment set of guidelines.

“We would also like the strategy to include reference to the differences between acute, recurrent and chronic UTIs. We would also like to see reference to the potential dangers of untreated, more complicated UTIs.”

The NHS has been contacted for comment.

National Institute for Health and Care Excellence (NICE), which issues guidance on treatments and medicines, said: “We have prioritised requests for further research around symptoms and signs of long-term (chronic) UTIs in the form of our research recommendations.

“In February last year NICE also published new quality standard which identified improvements in UTI diagnosis for women.

“NICE guidelines are not mandatory, but professionals are expected to give them due consideration when assessing patients and the right options for their treatment.

“NICE guidelines are regularly reviewed and updated, particularly if there are any significant changes to the evidence base. We follow an established process when making sure our published guidelines are current and accurate and take a proactive approach to responding to events that may impact on our recommendations.”