Navigating healthcare, managing life, or falling through the cracks? A theory-informed systematic review of the chronic burden faced by women with recurrent urinary tract infections.

OBJECTIVES: Recurrent urinary tract infections (rUTIs) are often treated as discrete biomedical episodes, yet women experience them as chronic, disruptive, and stigmatized conditions. This systematic review synthesizes empirical evidence on women’s lived experiences of rUTIs, situating and evaluating findings against frameworks of chronic illness and gender. METHODS: Following PRISMA guidelines, we searched seven databases for studies on adult women with rUTIs (≥ 2 in 6 months OR ≥ 3 in 12 months) across healthcare navigation, emotional wellbeing, work, and family/relationships, published January 2015-March 2025. Only peer-reviewed empirical studies in English were included. Study quality was appraised using QuADS framework. RESULTS: From 3,628 records screened, fifteen studies were included. Women reported fragmented care, repeated antibiotic use with limited preventive guidance, and mistrust of providers. Emotional burdens such as anxiety and stigma were common, often linked to hygiene or sexuality. rUTIs disrupted intimacy, family planning, and work, though these domains were rarely examined in depth. While findings showed relevance to chronic illness and gender frameworks, few studies engaged these perspectives explicitly, leaving results descriptive rather than analytic. Quality appraisal showed frequent gaps in stakeholder involvement, sampling documentation, and methodology justification. CONCLUSIONS: While rUTIs create chronic and gendered burdens extending beyond clinical symptoms, research has yet to fully draw on theoretical frameworks to capture women’s lived experiences. Moving forward, research and policy should look beyond biomedical framings and adopt theory-informed, intersectional, and patient-centered approaches that address not only episodic challenges but also long-term difficulties, structural barriers, and equity in care.