Recurrent UTIs
Recurrent urinary tract infections (UTIs) — generally two or more infections in six months, or three or more in a year — are one of the most common reasons women seek urologic care. IM Care Family NP evaluates and manages recurrent UTIs via telehealth for patients located anywhere in New York State. Our goal is to identify what's contributing to the pattern and build a plan to help reduce how often infections occur.
Common Symptoms
Burning or pain with urination
Urinary urgency or frequency
Lower abdominal or pelvic discomfort
Cloudy, strong-smelling, or blood-tinged urine
Symptoms that keep returning after treatment
What May Contribute
Anatomic or hormonal factors, including low estrogen after menopause
Sexual activity or changes in bladder emptying habits
Incomplete bladder emptying or pelvic floor dysfunction
Hydration and toileting habits, or constipation
In some cases, an underlying structural or anatomic factor
This is general information, not a diagnosis — many different conditions can cause similar symptoms.
How We Evaluate
Review of your symptom pattern, frequency, and prior urine culture results
Urinalysis and urine culture when an active infection is suspected
Discussion of hormonal status, especially for postmenopausal patients
Referral for imaging or urology evaluation when infections are complicated or unusual
Treatment Options We May Discuss
Targeted antibiotic treatment based on culture results, when appropriate
Non-antibiotic preventive strategies, such as hydration and voiding habits
Vaginal estrogen therapy for postmenopausal patients, when clinically appropriate
Low-dose preventive antibiotic strategies in select cases
Referral to urology or urogynecology for recurrent or complicated cases
Can This Be Managed by Telehealth?
Many recurrent UTI visits — including symptom review, treatment of an active infection, and preventive planning — can be handled by telehealth. Some situations, such as evaluating blood in the urine, fever, or infections that don't respond to treatment, may require urine testing at a Quest or LabCorp location near you, or a referral for imaging.
Frequently Asked Questions
Real questions patients ask us about this condition.
Can a nurse practitioner treat a UTI over telehealth in New York?
Yes. A nurse practitioner can evaluate UTI symptoms, review urine testing, and prescribe appropriate treatment by telehealth for patients located in New York State at the time of the visit, when a physical exam isn't needed.
Why do I keep getting UTIs even after treatment?
Recurrent UTIs can result from a combination of factors, including hormonal changes, incomplete bladder emptying, or anatomic factors. Identifying the underlying pattern is often key to reducing how often they occur.
Do I need a urine culture before starting antibiotics?
A urine culture helps confirm the diagnosis and identify the most effective antibiotic. Depending on your history and symptoms, treatment may sometimes start before culture results are back.
Can vaginal estrogen help prevent UTIs after menopause?
For many postmenopausal women, low-dose vaginal estrogen may help reduce how often UTIs occur by supporting vaginal tissue health. This is something we can discuss based on your individual history.
When to Seek Urgent Care
Contact urgent care, an emergency room, or call 911 right away if you experience:
• Fever or chills
• Flank or back pain (possible kidney infection)
• Blood in the urine
• Nausea or vomiting with urinary symptoms
• Inability to urinate
Ready to Talk to a Provider?
Schedule a consultation with Inga Melnikova, DNP, FNP-C to discuss your symptoms and next steps.
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