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