Chronic Urinary Tract Infections

Allison Gardner Excerpts

Wednesday 21st May 2025 Westminster Hall

[Dr Allison Gardner (Stoke-on-Trent South) (Lab)]

It is an honour to serve under your chairship, Sir Desmond. I am not well today for the very reason that we are here. I may need to sit down during my speech if that is okay. I am deeply grateful to the hon. Member for Sutton and Cheam (Luke Taylor) for securing this incredibly important debate. [Interruption.]

[Jim Shannon (Strangford) (DUP)]

This is a difficult subject for those who suffer from this condition. I will give an example in my speech, as one of my staff members suffers from it. We are deeply indebted to the hon. Member for Sutton and Cheam (Luke Taylor) for bringing this forward. It is important to hear personal stories from sufferers, such as the hon. Member for Stoke-on-Trent South (Dr Gardner), and that they are given the opportunity to express themselves on the importance of this issue to them personally and to all our constituents.

[Dr Gardner]

As hon. Members may have guessed, this debate is not only important to thousands of women across the country—according to the Chronic Urinary Tract Infection Campaign, about 1.7 million women suffer from chronic UTIs—but incredibly personal to me. I have suffered from UTIs as a result of menopause for more than 10 years, and received a diagnosis of chronic UTI in 2023.

I do not think many people realise how debilitating and excruciating chronic UTI can be. At my worst, I wondered how I could go on. I even changed from a beloved lecturing job to one at NICE because I wanted to change things from within, and it is why I am an MP now. I have tried almost everything; I was even considering—as a final step before the final, final step—having my bladder removed.

Although my NHS consultant gave me Hiprex—methenamine hippurate—thank God, which is life-changing for me, he finally shrugged his shoulders and said that I would just have to live with this condition. In desperation, I tracked down a specialist who worked in private practice. How lucky I was to have the money. I can confidently claim that Dr Catriona Anderson saved my life, which I do not say lightly.

Chronic UTIs can lead to hospitalisation—I have been twice—and sepsis and death. I have a long list of all the drugs that I am on, but I will not read it out. I believe this is another case of how women’s medical conditions continue to be misunderstood, under-researched and underfunded. To illustrate that point, there is a belief that UTIs are more serious in men than in women. I acknowledge that men’s physiology—men have a longer urethra than women—means that they are less likely to develop a UTI, although the possible presence of an enlarged prostate means that they may experience restrictive urine flows and develop a UTI. That is certainly the case in older men. Consequently, all men are recommended seven-day courses of antibiotics compared with the three-day courses that women are recommended. By the way, there are three antibiotics to treat UTIs. Trimethoprim and nitrofurantoin are the top ones, but I am allergic to them, so I am on cephalexin when I need it.

There is a lack of acknowledgement that poorly treated UTIs can lead to bacteria becoming embedded in bladders. Incidentally, a much shorter journey in women means that the diligence afforded to men is not afforded to women. In addition, women’s immune response to pathogenic bacteria in the bladder is oestrogen-dependent, and so it is also age-related. Lack of official recognition of chronic UTIs means that women do not receive treatment equal to what men. I am a molecular biologist, but I will not bore Members by setting out the different types of receptors in the urethral lining of the bladder.

I will further illustrate this point in simpler terms. A campaigner told me how her doctor, who repeatedly prescribed her three-day antibiotic courses for her chronic UTI, prescribed her husband, when he presented with a UTI for the first time, a month-long course, which would entirely clear the infection, of course, and minimise risk of recurrence. That says it all. Incidentally, chronic prostatitis is recognised by NICE.

As has been mentioned, for many women—approximately 70%—three-day courses will be sufficient, but for rest of women, three-day courses clear only some bacteria. Those that remain are relatively resistant; they then increase in population and there is recurrence. Essentially, repeated short courses establish a system of natural selection for resistant bacteria. It also means that the remaining bacteria then have time to invade the bladder and become embedded, finally leading to chronic UTIs. So, patients are stuck in a loop.

The use of the useless urine dipstick test, which is no more accurate than the toss of a coin, and of the midstream urine test, which is even worse, means that infections go undetected. As a result, no antibiotics are prescribed until the infection gets worse and, finally, a short course of antibiotics is prescribed. However, the infection is still not fully cleared, so the loop starts again. The infection then becomes embedded in the bladder wall and chronic UTI develops.

Short-term antibiotic courses often do not treat chronic UTIs, because dormant populations of bacteria exist within the bladder wall. Your life revolves around desperately trying to convince doctors to prescribe a course that you know will work for you. I am due to move house soon and I am petrified of having to move GPs, which would mean again starting this battle of trying to convince a GP to take me seriously. I understand concerns around antibiotic resistance and the medical hesitancy in prescribing longer courses of antibiotics. However, the solution is not to minimise antibiotic use; it is to get the diagnosis right, treat thoroughly, recognise the existence of chronic UTIs and prevent their development.

I am concerned by the lack of research and guidelines for diagnosis and treatment of chronic UTIs. We could prevent them all together if we get things right. I am particularly excited by the UTI vaccine, which is not currently available in the UK. Prevention of UTIs would not only save the NHS countless hours and money, but save people from living miserable lives.

In April, the Minister for Care said in a response to a written question:

“there are no current plans to train GPs and urologists on recognising the symptoms of chronic UTIs”.

Also, current NICE guidelines do not contain guidance for chronic UTIs. This situation must change. Too many women are being left in unbearable pain without a proper diagnosis or appropriate medication.

I will be very quick now, Sir Desmond; you have been very patient with me. About 50% of all antibiotics are prescribed for UTIs. However, each year there are thousands of deaths from UTIs and approximately 200,000 A&E admissions are due to UTI-related illnesses. The cost of UTIs to the NHS, as well as to people’s lives, is huge.

This issue is personal for me. It is also personal for the millions living with the pain, frustration and isolation of chronic UTIs. Will the Minister meet me and others, including campaigners, to discuss how we can improve diagnostic tools, develop guidance and ensure that people suffering from this condition receive the care that they deserve?

Thank you for your indulgence, Sir Desmond.