Recurrent urinary tract infections in primary care: a qualitative study of women’s experiences

BACKGROUND: Urinary tract infections (UTIs) are highly prevalent, affecting up to 50% of women during their lifetime. Among these, 20-30% develop recurrent UTIs (rUTIs), defined as ≥ 2 UTIs within 6 months or ≥ 3 UTIs within 12 months. In addition to physical symptoms, existing research describes how rUTIs affect women's quality of life, mental well-being, and intimate and social relationships. Few studies have investigated how women experience encounters with primary care and how rUTIs shape women's self-image and illness perceptions. The objective of this study was to explore how premenopausal women experience the impact of living with rUTIs, as well as how they experience the encounters with GPs in a Danish primary care setting. METHODS: This qualitative study was based on semi-structured interviews with 12 premenopausal women. The data was analysed using thematic analysis. RESULTS: Three themes were identified: (1) clashes between practice routines and women's perceptions, highlighting how standardised diagnostic and treatment practices were experienced as lacking, and that women expressed a need for clearer management pathways and a more patient-centred approach, (2) lack of validation from the GP, reflecting how women felt dismissed and insufficiently acknowledged in clinical encounters; and (3) gendered illness perceptions, illustrating how these experiences shaped women's understandings of their condition, leading to self-blame, normalisation, or feelings of injustice. CONCLUSION: rUTIs are highly distressing for women and the encounter with primary care often results in frustrations and unmet needs. Perceiving primary care routines as unclear can leave women feeling dismissed, compromise the patient-doctor relationship and affect the women's self‑image and illness perceptions. Improving rUTI management in primary care requires greater attention to women's lived experiences. GPs should recognize the broader impact of recurrent symptoms and ensure clear clinical routines that accommodate the recurrent condition rather than relying on repeated tests and prescriptions. Strengthening shared decision-making and aligning care with women's needs and understandings of health are essential for better support.