Here’s an interesting question that came up during this week’s Geriatrics for Caregivers Q&A call:
What can be done when an elderly woman has bacteria in her urine but no symptoms, and how might a urology consultation help?
According to the caller, a friend in her 90s had been having bacteria in her urine, but no symptoms. Despite treatment with antibiotics, she was still having urine in the bacteria, so the doctor had recommended chronic antibiotics and a referral to urology.
(Now, these Q&A sessions — and these blog posts, for that matter — are for health education purposes only, so it’s not possible to make specific recommendations on how this elderly woman should be treated. The doctors involved are able to talk to her, examine her, and review her medical history, and that will affect what kinds of recommendations they make.)
On the call, I shared some of what I know about this topic in general: that although urine is usually sterile, some people do develop chronic bacteria without having a urinary tract infection (UTI), and that we call this having a “colonized” bladder. I also noted that unless there are symptoms of a urinary tract infection (UTI), it wasn’t clear to me that treating the bacteria repeatedly would be helpful.
We went on to discuss the kinds of questions that a family could ask a doctor, to make sure that all the appropriate treatment options had been considered, and to better understand why the doctor was recommending a urologist. We also talked about applying a “benefits vs burdens” approach to going through the options with the doctor.
But after the call, I decided to look up the problem of “asymptomatic bacteriuria,” which is the technical term for having bacteria in the urine but no signs of UTI. (“Asymptomatic” means no symptoms.)
As often happens when I look things up, I learned some useful things! Below are the highlights, which I hope will be helpful to older adults and caregivers (and even doctors!) who encounter this health issue.
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