Why do UTIs Keep Coming Back?

Painful urination, frequent trips to the bathroom, and persistent discomfort are hallmark signs of a urinary tract infection, one of the most common bacterial infections, especially among women. In this episode of Health Matters, host Courtney Allison speaks with Dr. Larissa Rodriguez, urologist-in-chief at NewYork-Presbyterian and Weill Cornell Medicine, about what causes UTIs and why they are so common.Dr. Rodriguez explains how bacteria enter and infect the urinary tract, why women are at higher risk than men, and how factors such as menopause and changes in the vaginal microbiome can increase susceptibility to infection. She also discusses the symptoms of uncomplicated UTIs and the warning signs that an infection may have spread to the kidneys.The conversation explores the challenges of recurrent UTIs, including the role antibiotics can play in disrupting healthy bacteria and contributing to a cycle of repeated infections. Dr. Rodriguez shares current treatment strategies, explains why shorter and more targeted antibiotic courses are preferred, and discusses concerns about antibiotic resistance.Finally, she reviews emerging therapies and ongoing research, including methenamine, microbiome-based approaches, and vaccine development. She also separates fact from fiction when it comes to cranberry supplements, probiotics, hygiene myths, and other commonly discussed prevention strategies.Chapters00:00 – What Causes UTIs and Who Gets Them?Why urinary tract infections happen, why women are more susceptible, and common risk factors across the lifespan04:00 – Symptoms, Warning Signs, and Kidney InfectionsHow to recognize a UTI, when symptoms become serious, and signs an infection may have spread beyond the bladder05:40 – Recurrent UTIs and Antibiotic ResistanceWhy infections come back, how treatment works, and the importance of targeted antibiotic use08:15 – New Treatments, Prevention, and UTI MythsMethenamine, microbiome research, cranberry products, probiotics, and practical ways to reduce infection riskKey Topics CoveredUrinary tract infections (UTIs)Recurrent UTIsWomen's healthBladder infectionsKidney infectionsPyelonephritisUrologyUrinary symptomsMenopause and UTIsVaginal microbiomeAntibiotic resistanceUrine culturesUTI preventionMethenamineProbioticsCranberry supplementsD-mannoseVaginal healthPostmenopausal healthMicrobiome researchUTI vaccinesKidney healthAntibiotic stewardshipUrologic careKey TakeawayUTIs are extremely common, particularly among women, but recurrent infections should not simply be treated with repeated rounds of antibiotics. Understanding the role of the microbiome, obtaining proper testing, and working with a specialist when infections persist can help identify effective prevention strategies and reduce the risk of future infections.Doctor BioDr. Larissa Rodriguez is urologist-in-chief at NewYork-Presbyterian/Weill Cornell Medical Center and chair of the Department of Urology at Weill Cornell Medicine. She is a board-certified urologist with expertise in the surgical reconstruction of pelvic floor conditions. A clinical and basic scientist, Dr. Rodriguez has published more than 100 original studies in peer-reviewed journals such as the Journal of Urology, Urology, and Female Pelvic Medicine and Reconstructive Surgery. She is the principal investigator of the NIH-sponsored Multidisciplinary Approach to the Study of Urologic Pelvic Pain (MAPP) research network, which investigates the underlying causes of bladder pain syndrome and how best to treat it. Dr. Rodriguez has received numerous research grants and served as reviewer of multiple journals and member of study sections for the NIH, including its Kidney and Urologic Systems Function and Dysfunction Study Section. She has received multiple research awards from the American Urological Association as well as its Western Section, and the Society or Urodynamics, Female Pelvic Medicine, and Urogenital Reconstruction (SUFU). In 2008, Dr. Rodriguez received SUFU’s Paul Zimskind Award, which honors physicians who are within 10 years of completing residency or fellowship and have made significant contributions to the field of pelvic medicine and voiding dysfunction, primarily through basic and clinical research.Dr. Rodríguez earned her bachelor's degree in mathematics from the Massachusetts Institute