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Recurrent UTI and interstitial cystitis treatment in Salt Lake City

A bladder infection that returns a few weeks after the last one. Burning, pressure, and urgency, with a urine test that comes back clean. An evaluation helps separate infection from bladder pain and other causes of urinary symptoms in women and men. Elisabeth Ferlic, MD, is a board-certified urologist in Salt Lake City. She evaluates recurrent urinary tract infections (UTIs) and interstitial cystitis, then builds recurrent UTI treatment and bladder pain care around what the testing shows.

Ask about an appointmentCall 435-344-4760

Elisabeth Ferlic, MD

Board-certified urologist · Fellowship-trained in voiding dysfunction and female pelvic medicine

In this guide

Symptoms of recurrent UTIs and interstitial cystitis

Signs of a bladder infection

  • Burning or pain during urination
  • A strong, frequent urge to urinate with little urine passed each time
  • Cloudy, dark, or strong-smelling urine
  • Pressure in the lower abdomen, or blood in the urine

Signs of interstitial cystitis

  • Pain, pressure, or tenderness in the bladder area or pelvis
  • Pain that grows as the bladder fills and eases for a short time after urinating
  • Urinating often, day and night, in small amounts
  • Pain during or after sex
  • Flares tied to certain foods, stress, or, for women, the menstrual cycle

When to seek emergency care:

Fever, chills, pain in your back or side, or nausea and vomiting along with urinary symptoms can mean the infection has reached a kidney. Go to urgent care or an emergency room the same day. Blood in the urine always deserves an evaluation.

Bladder symptoms that keep coming back

Recurrent infection and interstitial cystitis can cause similar symptoms, but they need different care. Other conditions can also cause bladder symptoms.

A recurrent UTI means two or more bladder infections within six months, or three or more within a year, each confirmed by a urine culture. Bacteria, most often E. coli from the bowel, reach the bladder and multiply. Antibiotics clear the infection, then another follows.

Interstitial cystitis, also called bladder pain syndrome or painful bladder syndrome, is long-term pain, pressure, or discomfort in the bladder area together with frequent or urgent urination. It lasts more than six weeks with no infection or other clear cause, and antibiotics don't treat it. Symptoms range from mild to severe and often come in flares.

Some people have both, and a UTI can set off a flare of interstitial cystitis.

A woman walking a foothill trail above the Salt Lake Valley
Elisabeth Ferlic, MD

Why see Dr. Ferlic for recurrent UTIs or bladder pain

Dr. Ferlic is a board-certified urologist and fellowship-trained in voiding dysfunction and female pelvic medicine. That training covers the questions at the center of both conditions: whether the bladder empties, how the nerves and pelvic floor are working, and what has changed in the tissue.

She treats women and men, and visits aren't rushed. Before ordering any test, she reviews your history and past results; conservative treatment comes before any procedure. If your symptoms overlap with menopause, prostate trouble, or a nerve condition, the same physician manages those too. Read more about Dr. Ferlic, women's pelvic health, and men's urology.

What are my options?

A starting point for the conversation, not a prescription. Your evaluation decides what fits.

  • Repeat infections confirmed by culture

    Two or more in six months, or three or more in a year

    Correct what feeds the infections

    A bladder that doesn't empty, a stone, or an enlarged prostate comes first

  • Infections after menopause

    Falling estrogen thins the tissue and reduces protective bacteria

    Low-dose vaginal estrogen

    Restores the tissue and the protective bacteria

  • Bladder pain with negative cultures

    Symptoms that flare and settle, with little relief from antibiotics

    Stepped interstitial cystitis care

    Trigger changes, pelvic floor therapy to relax muscles, and medication

  • Bladder pain that persists

    After earlier steps haven't controlled symptoms

    Procedures for selected patients

    Hydrodistension, Hunner lesion treatment, bladder Botox, or nerve stimulation

Recurrent UTI treatment options

Recurrent UTI treatment begins with clearing the infection you have. After that, the work is preventing the next one, and prevention starts with the least invasive step that fits the cause.

Vaginal estrogenNon-antibiotic preventionPreventive antibiotics
What it involvesLow-dose vaginal estrogen for women in perimenopause and after menopauseCranberry supplements, or a daily urinary antisepticA single dose after sex, a daily low dose for set months, or a prescription you start at symptoms
EvidenceOne of the best-supported ways to prevent UTIsCranberry has research behind it; the evidence for D-mannose by itself is weakAn option for prevention, one among several
Trade-offVery little reaches the rest of the bodyThe urinary antiseptic is a medication you take every dayLong-term use raises the risk of resistance, so it isn't the default

  • Vaginal estrogen

    What it involves
    Low-dose vaginal estrogen for women in perimenopause and after menopause
    Evidence
    One of the best-supported ways to prevent UTIs
    Trade-off
    Very little reaches the rest of the body

  • Non-antibiotic prevention

    What it involves
    Cranberry supplements, or a daily urinary antiseptic
    Evidence
    Cranberry has research behind it; the evidence for D-mannose by itself is weak
    Trade-off
    The urinary antiseptic is a medication you take every day

  • Preventive antibiotics

    What it involves
    A single dose after sex, a daily low dose for set months, or a prescription you start at symptoms
    Evidence
    An option for prevention, one among several
    Trade-off
    Long-term use raises the risk of resistance, so it isn't the default

  • Correct what feeds the infections

    If the bladder does not empty, or a stone or an enlarged prostate is in the way, prevention begins there.

  • Fluids and daily habits

    Women who drink less than about 50 ounces (1.5 liters) of fluid a day have fewer infections after they increase their water intake. Urinating regularly and after sex, and switching away from spermicides and diaphragms, are low-risk steps.

  • Vaginal estrogen after menopause

    For women in perimenopause and after menopause, low-dose vaginal estrogen is one of the best-supported ways to prevent UTIs. It restores the tissue and the protective bacteria, and very little reaches the rest of the body. It is part of Dr. Ferlic's hormone and menopause care.

  • Non-antibiotic prevention

    Cranberry supplements have research behind them; the evidence for D-mannose by itself is weak. A urinary antiseptic, a daily medication that is not an antibiotic, is another option.

  • Antibiotics, used deliberately

    An active infection needs an antibiotic, chosen from the culture and taken for the shortest course that works. For prevention, options include a single dose after sex, a daily low dose for a set number of months, or a prescription you start when symptoms begin, after a culture is sent. Long-term antibiotics raise the risk of resistance, so they stay one option among several rather than the default.

How recurrent UTIs and interstitial cystitis differ, and why they get confused

Both conditions cause urgency, frequent urination, and discomfort low in the pelvis, so they can feel identical. The difference shows up in the urine culture. With a true infection, the culture grows bacteria, and symptoms clear within a few days of the right antibiotic. With interstitial cystitis, the culture is negative, and antibiotics bring little or no lasting relief.

The confusion usually starts when symptoms are treated without a culture. Several rounds of antibiotics later, nobody can say which episodes were infections. Other conditions imitate both, including overactive bladder, tight pelvic floor muscles, vaginal tissue changes after menopause, and, in men, inflammation of the prostate.

Recurrent UTI Interstitial cystitis
Urine culture Grows bacteria during an episode Negative
Usual pattern Separate episodes with symptom-free stretches between them Ongoing symptoms that flare and settle
Type of pain Burning during urination Pain or pressure as the bladder fills, eased for a short time by urinating
Response to antibiotics Symptoms clear within days Little or no lasting change
Goal of care Find why infections recur and prevent the next one Control symptoms and reduce flares

Causes and risk factors

  • Why UTIs keep returning

    Women get more bladder infections than men because the urethra is short and sits close to the source of the bacteria. Several factors make repeat infections more likely:

    Men under 50 rarely get bladder infections. When a man does, and especially when infections repeat, the cause is often a blockage such as an enlarged prostate or a stone.

  • What is known about interstitial cystitis

    The cause is not fully understood. Leading explanations include a defect in the bladder's protective lining, inflammation, and oversensitive nerves. It is more common in women, in people over 30, and in people with other long-term pain conditions such as irritable bowel syndrome or fibromyalgia. Common flare triggers are certain foods and drinks, stress, holding urine too long, sex, and urinary tract infections.

How each condition is diagnosed

The evaluation starts with your history: when symptoms began, which antibiotics you took, and whether they helped. Bring past urine culture results if you have them. They show whether the earlier episodes were infections at all.

  • Testing for recurrent UTIs

    • Urinalysis and urine culture with every episode, collected before antibiotics start. The culture names the bacteria and the antibiotics that work against it.
    • A bladder scan after you urinate, to show whether the bladder empties
    • A pelvic exam for women, to look for prolapse and the tissue changes of menopause
    • Imaging or cystoscopy when there is a reason, such as blood in the urine, a history of stones, or repeat infections in a man

    Bacteria in the urine without symptoms usually do not need antibiotics. Pregnancy and some urologic procedures are exceptions. Follow the testing plan from your clinician.

  • Testing for interstitial cystitis

    No single test confirms interstitial cystitis. The diagnosis comes from ruling out other causes of the same symptoms, using a bladder diary, a urinalysis and culture, and an exam that checks the pelvic floor muscles for tenderness. Cystoscopy, a thin camera passed into the bladder, is used for selected patients to rule out other conditions and to look for Hunner lesions, the inflamed patches found in a small share of people with interstitial cystitis.

Interstitial cystitis treatment options

No single interstitial cystitis treatment works for everyone. Care moves in steps, and many people do best with a combination.

  • Diet, fluids, and stress

    Caffeine, alcohol, carbonated drinks, citrus, tomatoes, and artificial sweeteners are common triggers. Remove them for a few weeks, then add them back one at a time to learn which ones affect you. Steady hydration, gentle activity, and stress management reduce flares for many people.

  • Bladder retraining and pelvic floor physical therapy

    Bladder retraining slowly lengthens the time between bathroom trips. Pelvic floor physical therapy for bladder pain focuses on relaxing and releasing tight muscles. Strengthening exercises such as Kegels can make this condition worse.

  • Oral medication

    Several types of medication can ease bladder pain and urgency, and some take weeks or months to show an effect. Dr. Ferlic reviews what each one helps and when to stop one that isn't working.

  • Bladder instillations

    Bladder instillations place medication into the bladder through a catheter. The medicine, treatment schedule, and availability depend on the clinical plan. Ask whether this option fits your symptoms and where it can be provided.

  • Procedures for symptoms that persist

    For selected patients, the next steps include cystoscopy with bladder stretching (hydrodistension) under anesthesia, treatment of Hunner lesions when they are present, bladder Botox, or sacral nerve stimulation for selected symptoms. Some uses for bladder pain are outside the approved indication, and benefits, risks, and alternatives need an individual discussion. Major surgery is rarely needed.

Request an appointment or call 435-344-4760.

What to expect

With a confirmed infection, most people feel better within a few days of starting the right antibiotic. A prevention plan takes several months to judge, and a repeat culture guides the next step if symptoms return.

Interstitial cystitis improves more gradually. It often takes several weeks or months to see a change, and finding the right combination involves some trial and error. It is not life-threatening, and it does not lead to bladder cancer.

Past cultures and treatment records help clarify either condition. Ask whether a records review or virtual visit fits your concern and what in-person testing is needed. Reach out and ask about the next step.

Prevention and self-management

These habits support the medical plan for either condition:

  • Drink enough water that your urine stays pale yellow.
  • Don't hold urine for long stretches. Empty your bladder every three to four hours during the day, and after sex.
  • Ask for a urine culture before you start an antibiotic, and keep a copy of every result.
  • During an interstitial cystitis flare, try heat or a cold pack over the lower abdomen, loose clothing, and extra water to dilute the urine.
  • If you smoke, stopping reduces bladder irritation.

Benefits and risks, side by side

Every treatment has trade-offs. Your history and your goals decide which ones matter most.

What treatment can address

  • Bladder infections that keep coming back
  • Bladder pain and pressure with a negative culture
  • Frequent, urgent urination day and night
  • Flares of interstitial cystitis

What to weigh first

  • Whether past episodes were confirmed by a urine culture
  • Long-term antibiotics raise the risk of resistance
  • Interstitial cystitis care can take weeks or months to show a change
  • Strengthening exercises such as Kegels can make interstitial cystitis worse
  • Some procedure uses for bladder pain are outside the approved indication

What happens at the first visit?

The visit starts with what has changed and what you want help with. Any treatment and follow-up plan is specific to you.

  1. Talk through your symptoms

    Bring your concerns, medication list, and relevant medical history.

  2. Decide what needs checking

    Testing depends on your symptoms and history, and some concerns need a separate workup.

  3. Discuss a plan and follow-up

    Review benefits, risks, alternatives, and what to watch for.

Before you schedule

Ask which appointments are available and whether your concern suits a video visit or needs an in-person evaluation.

Ask about an appointment

Here’s what our great patients say

I am so grateful that Dr Ferlic was the doctor available to take care of my emergency kidney stone surgery. I had met with multiple urologists prior to needing this surgery and none of them seemed as compassionate or as competent and Dr. Ferlic.
Jill Smith

Frequently asked questions

Still have a question?

Call now: 435-344-4760

How many UTIs count as recurrent?

Two or more infections in six months, or three or more in a year, each confirmed by a urine culture. If you've reached that number, it's reasonable to have an evaluation to find the cause.

Why do I have UTI symptoms when my urine culture is negative?

Several conditions cause the same burning, urgency, and pressure without an infection, including interstitial cystitis, overactive bladder, tight pelvic floor muscles, and tissue changes after menopause. A negative culture calls for reassessment. Your clinician can decide whether further testing or a different diagnosis fits; don't repeatedly start antibiotics without advice.

Is interstitial cystitis the same as a chronic UTI?

No. Interstitial cystitis is a long-term bladder pain condition with no infection present, and antibiotics do not treat it. The two are often confused because the symptoms overlap and a real UTI can trigger a flare.

Do men get recurrent UTIs or interstitial cystitis?

Yes. Bladder infections are uncommon in younger men, so repeat infections usually point to a cause such as an enlarged prostate, a stone, or a bladder that does not empty. Men also develop interstitial cystitis, and their symptoms are often attributed to the prostate before the bladder is considered.

Can recurrent UTIs be prevented without daily antibiotics?

Often, yes. Options include treating the underlying cause, drinking more water, vaginal estrogen after menopause, cranberry supplements, and a non-antibiotic urinary antiseptic. Preventive antibiotics remain available when those measures are not enough.

Does interstitial cystitis ever go away?

For many people it is a long-term condition that improves with treatment and flares from time to time. Some people see their symptoms fade for long periods. It does not shorten life expectancy or turn into bladder cancer.

Related care

Talk with a urologist about bladder symptoms that keep returning

You don't need a referral to reach out. Call 435-344-4760 or request an appointment, and the practice will tell you how the practice can help. Core Urology and Pelvic Health serves women and men across the Salt Lake Valley.

This page is for general education and is not medical advice.

Ask about an appointmentCall 435-344-4760