Ask our Expert – Mr George Fowlis

Discussing UTI’s with expert Urologist

Mr George Fowlis

Mr George Fowlis, Consultant Urologist at Highgate Private Hospital


Dear George,

I was troubled with cystitis many years ago in my twenties. Now I am in my sixties and the symptoms have returned. I have had several courses of antibiotics from my GP. They help for a while but the symptoms regularly recur. What else can I do?




Dear Tracey,

Thank you for getting in touch. The first steps I would advise is to complete a Midstream Specimen of Urine (MSU) to check for an infection. If a urinary tract infection (UTI) is present it should initially be treated with a 2-week course of the appropriate antibiotic.

If the problem persists I would advise an ultrasound scan of the urinary tract to be arranged to exclude any complicating factors such as bladder stones or incomplete bladder emptying.

To discuss further treatment options a referral should be made to an Urologist. The treatment options include:

  • Simple lifestyle changes (increased fluid intake, emptying the bladder before and after intercourse, avoiding acidic/spicy foods & drinks, potassium citrate, cranberry juice)
  • Topical oestrogen cream to the introitus
  • Prophylactic antibiotics daily for 3 to 6 months
  • A simple operation on the water pipe called a therapeutic urethral dilatation (TUD)
  • Bladder installations once a week for 6 weeks with a drug called Cystistat.

Fortunately, most women do respond to a treatment or combination of treatments. So, Tracey, if you feel antibiotics are not as effective anymore, hopefully, the treatment options above will be helpful in managing your cystitis.

Best Wishes, George


Mr George Fowlis is a Consultant Urologist at Highgate Private Hospital, specialising in Oncology, particularly prostate, renal and testicular cancer; stones, & endourology

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