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Preventing recurrent cystitis

We recently reviewed the use of long-term low-dose chemotherapy to prevent recurrent urinary infections1 and briefly mentioned instructions which could be given to patients to supplement the drug treatment. The effectiveness of such measures is not readily tested by conventional trials, but many clinicians consider that they can help patients with bacterial cystitis and are also worth trying in those women with frequent symptoms of cystitis but without bacteriuria. Only about half the women presenting with urinary symptoms in general practice have infected urine. Recurrent urinary symptoms may be due to the urethral syndrome, gynaecological disorders or even psychiatric disturbances.