Management disparities in recurrent urinary tract infections: a survey-based study of diagnostic and prophylactic patterns

Recurrent urinary tract infections (rUTI) are a common clinical challenge. Our goal was to evaluate diagnostic workup, treatment patterns by General Practitioners (GPs) and specialists (Urologists/Gynecologists), and the psychosocial burden of rUTI. A cross-sectional study was conducted using a structured, internet-based questionnaire distributed via social media platforms and health forums targeted at women suffering from rUTIs. The survey assessed demographics, clinical history, diagnostic procedures, treatment modalities, and the impact of the condition on intimacy and professional life. Participants ( n = 85) were predominantly young, with 57.9% aged 18–35. 75.0% reported more than three infections per year, and 40.0% had a history of rUTI exceeding 10 years. While GP involvement was reported in 75.3% of cases, specialist involvement (urologist or gynecologist) in 69.4% of cases was associated with significantly higher utilization of long-term antibiotic prophylaxis (57.6% vs. 23.1%, p = 0.004) and non-antibiotic preventive agents (76.3% vs. 53.8%, p = 0.046). Referral for renal and urinary tract ultrasound was numerically higher in the specialist-involved group (72.9% vs. 50.0%, p = 0.050). Only 59.2% reported always performing a urine culture prior to antibiotic initiation, with no significant difference between provider groups. Psychosocial impact was substantial: 77.6% reported significant or severe QoL impairment, and 64.5% reported avoiding sexual intimacy, which strongly correlated with relationship strain ( p < 0.001). This internet-based study reveals a significant “specialist gap” in the management of rUTI. While digital recruitment may favor a younger demographic, the results highlight a profound long-term impact on work and intimacy, and a clear need for standardized diagnostic protocols across primary and specialist care.