Despite antibiotics knocking out urinary tract infections (UTIs), many people still suffer persistent, miserable symptoms, and doctors don’t know why. But now, researchers may have found the culprit: nerve overgrowth. By studying mice and human samples, they discovered that repeated UTIs trigger immune cells to release nerve growth factor (NGF), causing new pain nerves to sprout in the bladder. Recurrent UTIs are typically defined as three or more per year or two or more in six months, Dr. Jason Kim, urologist and director of the Stony Brook Medicine Women’s Pelvic Health & Continence Center, told The Epoch Times. The standard treatment is antibiotics targeting the type of bacteria involved. However, this often fails to address persistent discomfort after clearing the infection, while overusing antibiotics risks breeding drug-resistant bacteria. To better understand the issue, the scientists induced multiple UTIs in mice. Compared to UTI-free mice, the infected mice exhibited significant nerve growth. To identify the cause, researchers repeatedly infected mice bladders with E. coli bacteria and treated them with antibiotics. Even after the bacteria were eliminated, the mice continued displaying UTI symptoms, including frequent urination and pelvic sensitivity. Further analysis revealed that mice subjected to three infection/treatment cycles developed similar nerve overgrowth to that observed in human biopsies. Conversely, mice infected only once did not show an overabundance of nerves. Untreated infections could spread to the kidneys, causing pyelonephritis (kidney inflammation), potentially resulting in kidney failure, Dr. Kim said. In older patients, unrecognized UTIs may cause systemic infections affecting the entire urinary tract, leading to sepsis, organ dysfunction, and even death if not treated promptly. Mental status changes are often the first sign of UTIs in older adults, he noted. There are many reasons for recurrent UTIs. The first step is a full evaluation to identify the causes, Dr. Kim said. If no underlying issues are found and someone is getting three or more UTIs per year, different strategies are available, he explained. One strategy is behavioral modification, starting with evaluating how often the patient urinates. “We actually see this in a lot of teachers and nurses where they don’t have time to urinate throughout the day and they may not urinate all day long,” Dr. Kim said. “I might ask them to urinate more frequently to keep their bladder empty.” For
Women with pelvic floor dysfunction causing incomplete bladder emptying, Dr. Kim advised pelvic floor physical therapy. This involves consulting a physical therapist for a thorough evaluation and an individualized treatment plan.