Summary:
Urinary tract infections belong among the most common infectious diseases in adult women. Sporadic infection
is usually not a diagnostic and therapeutic problem. Recurrent lower urinary tract infections significantly decrease
the quality of life of the affected women. Colonisation of the vagina, vulva and the perineum by the uropathogens
is the main risk factor of any urinary infection, but only concomitant action of some other factor (e.g.
immunosuppression, urethral stenosis, urolithiasis, urethral diverticulum, diabetes and urinary incontinence) can
induce the recurrent infection. Correct primary treatment and proper used preventive method is highly advantageous
not only from the individual but also from the global point of view (high diagnostic and therapeutic expenses,
increase of resistance and imminent success decrease of the modern treatment). Continuous low dose antimicrobial
treatment is the most common prophylactic modality. Postcoital antimicrobial prophylaxis and
immunomodulative therapy are the other used modalities. Local vaginal estrogen therapy is recommended in
postmenopausal women. Estrogens improve the symptoms of the urogenital atrophy and decrease the vaginal pH,
which is very important in prevention of the pathological bacterial colonisation of the vagina. Decision about the
individual therapy and prophylaxis must be preceded by the evaluation of the risk factors with positives and negatives
of the used drug.
Key words:
recurrent urinary tract infections, complications, prophylaxis, antimicrobial therapy, immunomodulative
therapy, estrogens.
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