Minimum total score = 0, maximum total score = 40. Higher scores indicate higher pain intensity. Scores assess pain intensity in the past 24 hours

Minimum total score = 0, maximum total score = 40. Higher scores indicate higher pain intensity. Scores assess pain intensity in the past 24 hours

Patient Health Questionnaire-9; Minimum total score = 0, maximum total score = 27; higher scores indicate higher depression levels.

Patient Health Questionnaire-9; Minimum total score = 0, maximum total score = 27; higher scores indicate higher depression levels.

Generalised Anxiety Disorder - 7; minimum total score = 0, maximum total score = 21. Higher scores indicate higher anxiety severity.

Generalised Anxiety Disorder - 7; minimum total score = 0, maximum total score = 21. Higher scores indicate higher anxiety severity.

UCLA Loneliness Scale (V3); minimum total score = 0, maximum total score = 80; Higher scores indicate greater feelings of loneliness/social isolation.

UCLA Loneliness Scale (V3); minimum total score = 0, maximum total score = 80; Higher scores indicate greater feelings of loneliness/social isolation.

Measure assessing specific health problems impairing work capacity. Work impairment sub-scale minimum score = 0; maximum work impairment = 100; activity impairment minimum total score = 0, maximum activity impairment = 100. Higher scores indicate greater impairment due to health problems. The 'work impairment' subscale is only applicable to participants who report to be currently in work.

Measure assessing specific health problems impairing work capacity. Work impairment sub-scale minimum score = 0; maximum work impairment = 100; activity impairment minimum total score = 0, maximum activity impairment = 100. Higher scores indicate greater impairment due to health problems. The 'work impairment' subscale is only applicable to participants who report to be currently in work.

Female Sexual Distress Scale for assessing feelings of sexual distress. Minimum total score = 0, maximum total score = 52. Higher scores indicate greater sexual distress. Scores greater than 10 may indicate atypical/abnormal sexual distress. This scale is optional and therefore fewer participants than the total number provided data for analysis.

Female Sexual Distress Scale for assessing feelings of sexual distress. Minimum total score = 0, maximum total score = 52. Higher scores indicate greater sexual distress. Scores greater than 10 may indicate atypical/abnormal sexual distress. This scale is optional and therefore fewer participants than the total number provided data for analysis.

Patient Satisfaction Questionnaire - 18: 18 items assessing feelings about current medical care. The score represents the sum of seven different patient satisfaction domain scores (see more here: https://www.rand.org/content/dam/rand/www/external/health/surveys\_tools/psq/psq18\_scoring.pdf).

Higher scores indicate greater satisfaction with medical care. Minimum score = 1; maximum score = 35.

Patient Satisfaction Questionnaire - 18: 18 items assessing feelings about current medical care. The score represents the sum of seven different patient satisfaction domain scores (see more here: https://www.rand.org/content/dam/rand/www/external/health/surveys\_tools/psq/psq18\_scoring.pdf).

Higher scores indicate greater satisfaction with medical care. Minimum score = 1; maximum score = 35.

Specialist doctors or nurses in urology or a closely related discipline, or general health doctors or nurses, with a minimum of 2 years of direct experience treating patients with recurrent UTI. This arm participated in a two-round Delphi consensus study to establish content validity of draft RUTISS and RUTIIQ items. Demographic data collected at enrolment are reported below. Pre-specified quantitative outcome measures were not administered to this arm, as participants were clinicians rather than rUTI patients.

Adult participants with a diagnosis of recurrent urinary tract infection who participated in one-to-one cognitive think-aloud interviews evaluating the comprehension, relevance, and acceptability of draft RUTISS and RUTIIQ items. Demographic data collected at enrolment are reported below. The pre-specified quantitative outcome measures were not administered as scored assessments in this arm, as the PROMs were under development at this phase; data collected from this arm consisted of qualitative item-level feedback only.

Total of all reporting groups

RUTISS; Total minimum score = 0, total maximum score = 170. Newly designed instrument that can measure the patient experience of recurrent UTI symptoms and pain and/or discomfort; Urinary symptoms sub-scale minimum score = 0, maximum score = 70; urinary pain sub-scale minimum score = 0, maximum score = 100; higher scores indicate higher symptom severity

Administered only to Arm 1 (Pilot Participants) during the Phase V PROM validation pilot, in line with the study design. Arms 2 (Expert Clinicians) and 3 (Cognitive Interview Participants) did not complete this measure as a scored assessment, as their study procedures did not include administration of the PROM as a quantitative instrument, instead focusing on qualitative assessment of PROMs in development. Summary statistics are therefore not available for Arms 2 and 3.

RUTIIQ; Total minimum score = 0, maximum score = 300. Higher scores indicate higher rUTI impact and psychosocial burden. Newly designed instrument that can measure the patient experience of recurrent UTI impact on personal wellbeing, social activities, work and daily activities, sexual activity, and satisfaction with UTI-related medical care; personal wellbeing sub-scale minimum score = 0; maximum score = 40; social wellbeing sub-scale minimum score = 0, maximum score = 50; work/activity interference sub-scale minimum score = 0, maximum score = 70; sexual wellbeing sub-scale minimum score = 0, maximum score = 40; patient satisfaction sub-scale minimum score = 0, maximum score = 100.

The sexual wellbeing subscale is optional and therefore fewer participants than the total number provided data for analysis.

Administered only to Arm 1 (Pilot Participants) during the Phase V PROM validation pilot, in line with the study design. Arms 2 (Expert Clinicians) and 3 (Cognitive Interview Participants) did not complete this measure as a scored assessment; their procedures focused on qualitative assessment of PROMs in development rather than quantitative administration. Summary statistics are therefore not available for Arms 2 and 3. The sexual wellbeing subscale is optional; fewer participants provided data.

RUTIIQ; Total minimum score = 0, maximum score = 300. Higher scores indicate higher rUTI impact and psychosocial burden. Newly designed instrument that can measure the patient experience of recurrent UTI impact on personal wellbeing, social activities, work and daily activities, sexual activity, and satisfaction with UTI-related medical care; personal wellbeing sub-scale minimum score = 0; maximum score = 40; social wellbeing sub-scale minimum score = 0, maximum score = 50; work/activity interference sub-scale minimum score = 0, maximum score = 70; sexual wellbeing sub-scale minimum score = 0, maximum score = 40; patient satisfaction sub-scale minimum score = 0, maximum score = 100.

The sexual wellbeing subscale is optional and therefore fewer participants than the total number provided data for analysis.

Administered only to Arm 1 (Pilot Participants) during the Phase V PROM validation pilot, in line with the study design. Arms 2 (Expert Clinicians) and 3 (Cognitive Interview Participants) did not complete this measure as a scored assessment; their procedures focused on qualitative assessment of PROMs in development rather than quantitative administration. Summary statistics are therefore not available for Arms 2 and 3. The sexual wellbeing subscale is optional; fewer participants provided data.

(UTISA) 7 items assessing the severity of UTI symptoms in the past 24 hours; minimum total score = 0; maximum total score = 21. Higher scores indicate higher symptom severity and clinical cut-off for presence of a UTI = 3.

Administered only to Arm 1 (Pilot Participants) during the Phase V PROM validation pilot, in line with the study design, as a comparator measure for evaluating convergent and discriminant validity of the RUTISS and RUTIIQ. Arms 2 (Expert Clinicians) and 3 (Cognitive Interview Participants) did not complete this measure, as their study procedures did not include administration of validator instruments. Summary statistics are therefore not available for Arms 2 and 3.

(UTISA) 7 items assessing the severity of UTI symptoms in the past 24 hours; minimum total score = 0; maximum total score = 21. Higher scores indicate higher symptom severity and clinical cut-off for presence of a UTI = 3.

Administered only to Arm 1 (Pilot Participants) during the Phase V PROM validation pilot, in line with the study design, as a comparator measure for evaluating convergent and discriminant validity of the RUTISS and RUTIIQ. Arms 2 (Expert Clinicians) and 3 (Cognitive Interview Participants) did not complete this measure, as their study procedures did not include administration of validator instruments. Summary statistics are therefore not available for Arms 2 and 3.

Minimum total score = 0, maximum total score = 40. Higher scores indicate higher pain intensity. Scores assess pain intensity in the past 24 hours

Administered only to Arm 1 (Pilot Participants) during the Phase V PROM validation pilot, in line with the study design, as a comparator measure for evaluating convergent and discriminant validity of the RUTISS and RUTIIQ. Arms 2 (Expert Clinicians) and 3 (Cognitive Interview Participants) did not complete this measure, as their study procedures did not include administration of validator instruments. Summary statistics are therefore not available for Arms 2 and 3.

Minimum total score = 0, maximum total score = 40. Higher scores indicate higher pain intensity. Scores assess pain intensity in the past 24 hours

Administered only to Arm 1 (Pilot Participants) during the Phase V PROM validation pilot, in line with the study design, as a comparator measure for evaluating convergent and discriminant validity of the RUTISS and RUTIIQ. Arms 2 (Expert Clinicians) and 3 (Cognitive Interview Participants) did not complete this measure, as their study procedures did not include administration of validator instruments. Summary statistics are therefore not available for Arms 2 and 3.

Patient Health Questionnaire-9; Minimum total score = 0, maximum total score = 27; higher scores indicate higher depression levels.

Administered only to Arm 1 (Pilot Participants) during the Phase V PROM validation pilot, in line with the study design, as a comparator measure for evaluating convergent and discriminant validity of the RUTISS and RUTIIQ. Arms 2 (Expert Clinicians) and 3 (Cognitive Interview Participants) did not complete this measure, as their study procedures did not include administration of validator instruments. Summary statistics are therefore not available for Arms 2 and 3.

Patient Health Questionnaire-9; Minimum total score = 0, maximum total score = 27; higher scores indicate higher depression levels.

Administered only to Arm 1 (Pilot Participants) during the Phase V PROM validation pilot, in line with the study design, as a comparator measure for evaluating convergent and discriminant validity of the RUTISS and RUTIIQ. Arms 2 (Expert Clinicians) and 3 (Cognitive Interview Participants) did not complete this measure, as their study procedures did not include administration of validator instruments. Summary statistics are therefore not available for Arms 2 and 3.

Generalised Anxiety Disorder - 7; minimum total score = 0, maximum total score = 21. Higher scores indicate higher anxiety severity.

Administered only to Arm 1 (Pilot Participants) during the Phase V PROM validation pilot, in line with the study design, as a comparator measure for evaluating convergent and discriminant validity of the RUTISS and RUTIIQ. Arms 2 (Expert Clinicians) and 3 (Cognitive Interview Participants) did not complete this measure, as their study procedures did not include administration of validator instruments. Summary statistics are therefore not available for Arms 2 and 3.

Generalised Anxiety Disorder - 7; minimum total score = 0, maximum total score = 21. Higher scores indicate higher anxiety severity.

Administered only to Arm 1 (Pilot Participants) during the Phase V PROM validation pilot, in line with the study design, as a comparator measure for evaluating convergent and discriminant validity of the RUTISS and RUTIIQ. Arms 2 (Expert Clinicians) and 3 (Cognitive Interview Participants) did not complete this measure, as their study procedures did not include administration of validator instruments. Summary statistics are therefore not available for Arms 2 and 3.

UCLA Loneliness Scale (V3); minimum total score = 0, maximum total score = 80; Higher scores indicate greater feelings of loneliness/social isolation.

Administered only to Arm 1 (Pilot Participants) during the Phase V PROM validation pilot, in line with the study design, as a comparator measure for evaluating convergent and discriminant validity of the RUTISS and RUTIIQ. Arms 2 (Expert Clinicians) and 3 (Cognitive Interview Participants) did not complete this measure, as their study procedures did not include administration of validator instruments. Summary statistics are therefore not available for Arms 2 and 3.

UCLA Loneliness Scale (V3); minimum total score = 0, maximum total score = 80; Higher scores indicate greater feelings of loneliness/social isolation.

Administered only to Arm 1 (Pilot Participants) during the Phase V PROM validation pilot, in line with the study design, as a comparator measure for evaluating convergent and discriminant validity of the RUTISS and RUTIIQ. Arms 2 (Expert Clinicians) and 3 (Cognitive Interview Participants) did not complete this measure, as their study procedures did not include administration of validator instruments. Summary statistics are therefore not available for Arms 2 and 3.

Measure assessing specific health problems impairing work capacity. Work impairment sub-scale minimum score = 0; maximum work impairment = 100; activity impairment minimum total score = 0, maximum activity impairment = 100. Higher scores indicate greater impairment due to health problems. The 'work impairment' subscale is only applicable to participants who report to be currently in work.

Administered only to Arm 1 (Pilot Participants) during the Phase V PROM validation pilot, in line with the study design, as a comparator measure for evaluating validity of the RUTISS and RUTIIQ. Arms 2 (Expert Clinicians) and 3 (Cognitive Interview Participants) did not complete this measure; their procedures did not include validator instruments. Summary statistics are therefore not available for Arms 2 and 3. Work impairment subscale applies only to those currently in work.

Measure assessing specific health problems impairing work capacity. Work impairment sub-scale minimum score = 0; maximum work impairment = 100; activity impairment minimum total score = 0, maximum activity impairment = 100. Higher scores indicate greater impairment due to health problems. The 'work impairment' subscale is only applicable to participants who report to be currently in work.

Administered only to Arm 1 (Pilot Participants) during the Phase V PROM validation pilot, in line with the study design, as a comparator measure for evaluating validity of the RUTISS and RUTIIQ. Arms 2 (Expert Clinicians) and 3 (Cognitive Interview Participants) did not complete this measure; their procedures did not include validator instruments. Summary statistics are therefore not available for Arms 2 and 3. Work impairment subscale applies only to those currently in work.

Female Sexual Distress Scale for assessing feelings of sexual distress. Minimum total score = 0, maximum total score = 52. Higher scores indicate greater sexual distress. Scores greater than 10 may indicate atypical/abnormal sexual distress. This scale is optional and therefore fewer participants than the total number provided data for analysis.

Administered only to Arm 1 (Pilot Participants) during the Phase V PROM validation pilot, in line with the study design, as a comparator measure for evaluating validity of the RUTISS and RUTIIQ. Arms 2 (Expert Clinicians) and 3 (Cognitive Interview Participants) did not complete this measure; their procedures did not include validator instruments. Summary statistics are therefore not available for Arms 2 and 3. This scale is optional; fewer participants provided data.

Female Sexual Distress Scale for assessing feelings of sexual distress. Minimum total score = 0, maximum total score = 52. Higher scores indicate greater sexual distress. Scores greater than 10 may indicate atypical/abnormal sexual distress. This scale is optional and therefore fewer participants than the total number provided data for analysis.

Administered only to Arm 1 (Pilot Participants) during the Phase V PROM validation pilot, in line with the study design, as a comparator measure for evaluating validity of the RUTISS and RUTIIQ. Arms 2 (Expert Clinicians) and 3 (Cognitive Interview Participants) did not complete this measure; their procedures did not include validator instruments. Summary statistics are therefore not available for Arms 2 and 3. This scale is optional; fewer participants provided data.

Patient Satisfaction Questionnaire - 18: 18 items assessing feelings about current medical care. The score represents the sum of seven different patient satisfaction domain scores (see more here: https://www.rand.org/content/dam/rand/www/external/health/surveys\_tools/psq/psq18\_scoring.pdf).

Higher scores indicate greater satisfaction with medical care. Minimum score = 1; maximum score = 35.

Administered only to Arm 1 (Pilot Participants) during the Phase V PROM validation pilot, in line with the study design, as a comparator measure for evaluating convergent and discriminant validity of the RUTISS and RUTIIQ. Arms 2 (Expert Clinicians) and 3 (Cognitive Interview Participants) did not complete this measure, as their study procedures did not include administration of validator instruments. Summary statistics are therefore not available for Arms 2 and 3.

Patient Satisfaction Questionnaire - 18: 18 items assessing feelings about current medical care. The score represents the sum of seven different patient satisfaction domain scores (see more here: https://www.rand.org/content/dam/rand/www/external/health/surveys\_tools/psq/psq18\_scoring.pdf).

Higher scores indicate greater satisfaction with medical care. Minimum score = 1; maximum score = 35.

Administered only to Arm 1 (Pilot Participants) during the Phase V PROM validation pilot, in line with the study design, as a comparator measure for evaluating convergent and discriminant validity of the RUTISS and RUTIIQ. Arms 2 (Expert Clinicians) and 3 (Cognitive Interview Participants) did not complete this measure, as their study procedures did not include administration of validator instruments. Summary statistics are therefore not available for Arms 2 and 3.