Urologist Questions Urinary Tract Infections


My mother is 87 years old. She has had a UTI for 4 months, and has been treated with several different antibiotics. They have not been successful. She feels miserable. I am at my wit's end with how to help her.

Female | 87 years old
Complaint duration: 4 months
Medications: numerous antibiotics
Conditions: on-going infection, low energy level, uncontrollable shaking

5 Answers

•R/O Kidney or bladder stones (need to see a urologist)
•Bacteria entering the urethra
•Changes in estrogen levels during menopause
•An abnormal urinary tract shape or function
A woman this age that has recurrent urinary tract infections needs to see a urologist to rule out further causes, including not emptying her bladder, and other potential causes of infections, including kidney stones or obstruction.

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Chronic urinary tract infections in the elderly are usually the result of arophic vaginitis. With the loss of hormones at menopause, the wall of the vagina thins out and is unable to support healthy bacteria to prevent urinary tract infections. As you know, the vagina and the bladder are neighbors, and after menopause the vagina becomes a bad neighbor. This can be reversed through a couple of different strategies. One is to provide hormonal replacement, which should be bioidentical, such as estradiol and progesterone. A non-hormonal solution is through radio frequency vaginal rejuvenation, ThermiVa. This treatment induces the growth of new healthy vaginal tissue. With the addition of oral probiotics, the vagina can support a colony of healthy bacteria to prevent the “bad” bacteria from causing urinary tract infections. I have used this strategy in several of my patients, with good success. Additional benefits are improved vaginal hygiene, appearance, and lubrication.

Clifford D. Gluck, MD, FACS
You can have her start probiotics for vaginal or urinary health. Her doctors need to get cultures with each infection so they give her the right one. She may also need a CT scan to rule out a fistula between her intestines and the bladder.
She may not have a UTI. There are many other things that can cause similar symptoms.