SELLEST OSAST
What should you do differently when a UTI becomes a recurring problem? In this episode of the Backtable Podcast, host Dr. Anjali Kapur is joined by physician-scientist Dr. Glenn Werneburg to discuss the latest approaches to recurrent urinary tract infections, including key updates from the 2025 AUA, CUA, and SUFU guidelines. They use real clinical cases to explore diagnosis, prevention, antibiotic selection, and the management of complex patients.
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Timestamps
00:00 - Introduction
04:05 - Case One: Recurrent UTIs
05:19 - Workup Basics
08:50 - Non-Antibiotic Prevention
11:42 - Antibiotic Prophylaxis Options
15:16 - Case Two: Asymptomatic Bacteriuria
19:14 - Case Three: Complex Patients
19:58 - Male vs. Female UTIs
21:22 - Neurogenic Bladder Workup
22:52 - Elderly Patients and ID Consults
25:01 - Case Four: Transplant ESBL
25:23 - Machine Learning for Antibiotics
29:49 - Catheter Biofilms
31:55 - Embedded Bladder Reservoirs
35:23 - Recurrent UTI Vaccine
36:23 - Future of Recurrent UTIs
39:04 - Wrap Up
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More about this episode
The doctors define recurrent UTI and outline the standard workup, including history, physical and pelvic exam, urinalysis, urine culture, and antibiotic sensitivities. They also review occasions where additional testing may be warranted. The discussion covers interpretation of urinalysis, non-antibiotic prevention options, and antibiotic prophylaxis strategies, with consideration of antibiotic resistance and microbiome disruption. They address asymptomatic bacteriuria and when treatment is indicated, along with management considerations for men, patients with neurogenic bladder or CIC, and elderly patients. Dr. Werneburg also discusses his work with machine learning tools to predict antibiotic susceptibility earlier, catheter biofilms, the concept of embedded bladder bacteria reservoirs, and his multidisciplinary complex UTI clinic.
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Resources
Recurrent Uncomplicated Urinary Tract Infections in Women: AUA/CUA/SUFU Guideline (2025)
https://www.auanet.org/guidelines-and-quality/guidelines/recurrent-uti
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BackTable Women's Health is the go-to podcast for gynecologists, gynecologic surgeons, and other healthcare professionals focused on women’s health.
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