Urinary Tract Infections — A Common Problem

Urinary Tract Infections are a frequent problem among older people. Urination, so easy that we don’t even notice it in our younger years, becomes more intrusive as we age. Infection, straining, and incontinence all occur more often as we age. A urinary infection can make pre-existing symptoms of prostrate disease or incontinence worse. Symptoms of urinary infection are burning or pain with urination, urgency, frequency, and sometimes fever. Fever accompanying urinary symptoms can be a sign of a more serious infection. Untreated, a bladder infection can progress to a kidney infection, which is more difficult to treat, and which sometimes requires intravenous antibiotics. Why do older people develop more urinary tract infections than younger ones?

In men, the prostrate often enlarges with age, compressing the urethra at the base if the bladder. Emptying the bladder can become more difficult, requiring straining, or the bladder may not fully empty, and the man must urinate very frequently, sometimes waking several times a night. Urinary retention (failing to completely empty the bladder) may allow bacteria to grow in the residual urine, causing a bladder infection. Urinary retention may occur for a number of reasons, including an enlarged prostate, nerve damage, pelvic radiation therapy, and some medications.

Women statistically have more bladder infections than men throughout life. In older women who don’t take estrogen supplements, the urethra becomes more dry, thin, and prone to infection. A woman’s urethra is already short and near the anus; when normal function is impaired, bacteria can very easily ascend into the bladder. Weakening of muscles, pressure from internal organs losing support, bladder catheterization or incontinence — all of these occur more frequently in older people, and all predispose to urinary tract infection.

How can a healthy older person stay that way? Several simple measures can help. Drink plenty of water — eight glasses or two quarts a day will keep the urine flowing and the bladder “flushed.” Don’t wait when you have the urge to urinate — like other muscles, the bladder functions best when it is not overstretched. Women should wipe from front to back after urination or bowel movements to avoid introducing bacteria from the colon into the urethra. Women should also urinate promptly after intercourse. Be alert for symptoms. Early treatment should prevent progression from a mild bladder infection to a more serious kidney infection.

E. Patricia Gill, M.D., is a primary care physician in internal medicine and a specialist in infectious disease. She is board certified in both internal medicine and infectious disease. She joined Longmont Clinic in April 1995.