Recurrent UTIs. What to expect from urogynecologist visit & treatment?

Post date: 2025-05-11 03:44:38

I'm on my my 3rd UTI in 2025, and I usually have them 2-3 times a year. I have an appointment scheduled with a urogynecologist in a month. What kind of exams and tests are typical? And what kind of treatments are typical? Any other advice?

The UTIs always happen within 1-2 days after sex. UTIs became more frequent after I gave birth 8 years ago (vaginally, no issues during delivery). Prior to baby, it was once every few years, only when I was traveling/camping with less access to showers. I'm already wiping front to back, husband and I are both showering immediately before sex, I pee immediately after sex and wipe with a baby wipe, I started taking D-mannose and cranberry capsules and a probiotic after a UTI in January, I always drink a lot of water, but the UTIs are still recurring. Macrobid always seems to take care of the infection within 2 days and then I feel fine for 1+ months until the next one starts (sometimes 6+ months) so it seems like the infection really does go away. My bloodwork is all fine, I just had my annual physical.

Seems like I am doing it all and my PCP suggested I see a urologist.

Questions:

Is a urogynecologist a better choice than a urologist? Or should I find a urologist instead?

What exams / exams / labs do they typically do?

What possible treatment options are there? I keep reading that the treatment is often a low-dose antibiotic as a preventative measure. Is that really better for antibiotic resistance and gut biome that a course of antibiotics when an infection occurs? I also read that surgery might help. 2 gynecologists over the last 2 years both confirmed that everything looks fine as far as they could see. But maybe a urologist is able to "see" more through testing versus visual exams?

Should I start showering immediately AFTER sex too, instead of waiting until the morning or a few hours? Seems unnecessary if there is no bacteria due to both of us showering prior to sex (husband doesn't have UTIs, 100% sure that there are no STDs), but I'll start doing that just in case.... even though that's the last thing I want to do at 11 PM when I just showered an hour earlier.

I started googling whether a bidet would help, but it seems mixed since it can spray bacteria towards the urethra.

Any other advice from someone who's been through this

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