Has anyone dealt with a “complicated UTI” that overlaps with gyn stuff? I’m trying to understand where gynecology fits versus urology and what to expect/ask for. A few specific things I’m confused about:
- What exactly makes a UTI “complicated” in a gyn context? Is it just pregnancy, kidney involvement, diabetes, anatomic issues, or does stuff like an IUD, pelvic floor dysfunction, or prolapse count too?
- If you have recurrent UTIs plus gyn factors (IUD, endo, BV/yeast history, peri/menopause changes), did your gynecologist manage it or refer to urology/nephrology? How do you get both on the same page?
- Testing: beyond a urine culture with sensitivities, did your gyn do a pelvic exam, vaginal swabs for BV/yeast, post-void residual, pelvic ultrasound, or check for prolapse/retention? Did anyone get a “test of cure” culture?
- Menstruation and cultures: if you’re on your period or spotting, how do you get a clean sample that won’t be rejected or give a misleading result?
- Vaginal microbiome: did treating BV/yeast or using vaginal estrogen (peri/post-menopause or postpartum) reduce UTIs for you? Any luck with probiotics (oral or vaginal) targeted at Lactobacillus?
- Birth control and UTIs: did anyone notice a difference with copper vs hormonal IUDs? Are spermicides/diaphragms as big a UTI trigger as people say? Any contraception that seemed “UTI-friendlier”?
- Sex and prevention: if you use postcoital strategies, what did your gyn suggest (timed antibiotics, methenamine hippurate, D‑mannose, cranberry)? If you’re TTC, what did they say is safe?
- Pregnancy: if you had a complicated UTI while pregnant or trying to conceive, what antibiotics or suppressive plans were used, and how often were cultures repeated?
- ESBL/resistance: for folks with resistant E. coli, what options did your gyn discuss, and did they coordinate with infectious disease?
- Differentiating UTI vs. bladder pain syndrome/IC or endo flares: did your gyn use any clues or tests to tell them apart?
- Pelvic floor angle: if you have retention or pelvic floor hypertonicity, did pelvic floor PT help reduce UTIs?
- Practical tips: hydration is obvious, but any evidence‑backed non‑antibiotic add‑ons your gyn recommended (methenamine, vaginal estrogen, timed voiding, avoiding certain lube products, etc.)?
Would love to hear what worked, what didn’t, and the questions you wish you’d asked your gyn at the start.