Persistent pain after a UTI may be due to an overgrowth of nerve cells

Many people experience ongoing pain even after a urinary tract infection has supposedly passed. Now, research suggests this may be due to an overgrowth of nerve cells in their bladders

By Chen Ly

1 March 2024

Urinary tract infections frequently cause people to need to urinate more often than usual

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Pain that persists even after a urinary tract infection has supposedly passed seems to be down to an overgrowth of nerve cells in the bladder.

Urinary tract infections (UTIs) are most commonly caused by the bacterium Escherichia coli making its way from faecal matter to the urethra, bladder or kidneys. Common symptoms include pain while urinating and the urge to urinate more often than normal. These infections mainly affect women, of whom around half develop a UTI at some point in their life.

“One of the major issues regarding urinary tract infections is its pretty high rate of recurrence,” says Soman Abraham at Duke University in North Carolina. “But after treatment, some people seem to have the same UTI symptoms even when there’s no longer an infection.”

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To understand the root of the ongoing symptoms, Abraham and his colleagues analysed bladder tissue biopsies from eight women who reported continued pelvic pain from recurrent UTIs, despite tests revealing there was no E. coli in their urine. They also collected biopsies from three women who had never knowingly had a UTI. No transgender people were included in the study.

The team found that those with persistent UTI symptoms had abnormal overgrowths of nerve cells in their bladders, compared with the other women. These nerve cells also had higher levels of a peptide called substance p, which causes pain and inflammation.