Wednesday, July 24, 2024

Urinary Tract Infection In Elderly Men

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Confusion Linked To Acute Cystitis Or Pyelonephritis

Your Healthy Family: Risks of urinary tract infections in older men

Studies including hospitalised patients are likely to also include patients with pyelonephritis, a condition likely to result in confusion in a fragile elderly person. However, the typical nursing home situation usually involves the suspicion of confusion caused by a lower UTI in an afebrile patient.

The primary aim of this review was not to evaluate the association between pyelonephritis and confusion. The primary question was if lower UTI with no fever in residents without a urinary catheter, with or without localised symptoms such as acute dysuria, urgency or frequency, is associated with confusion. This review concludes that current evidence does not provide a clear answer to this question.

Check If Its A Urinary Tract Infection

Symptoms of a UTI may include:

  • pain or a burning sensation when peeing
  • needing to pee more often than usual during the night
  • pee that looks cloudy
  • needing to pee suddenly or more urgently than usual
  • needing to pee more often than usual
  • lower tummy pain or pain in your back, just under the ribs
  • a high temperature, or feeling hot and shivery
  • a very low temperature below 36C

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Heid, M., 2021. Urinary Tract Infections in Men. WebMD. Available at: <> .

Kirby M, Chapple C, Jackson G, Eardley I, Edwards D, Hackett G, Ralph D, Rees J, Speakman M, Spinks J, Wylie K. Erectile dysfunction and lower urinary tract symptoms: a consensus on the importance of co-diagnosis. Int J Clin Pract. 2013 Jul 67:606-18. doi: 10.1111/ijcp.12176. Epub 2013 Apr 25. PMID: 23617950 PMCID: PMC3748789.

Pendick, D., 2022. UTI in Men: Causes, Symptoms, Treatment, and Prevention. Healthline. Available at: <> .

Cleveland Clinic. 2020. Urinary Tract Infections: Causes, Symptoms & Treatment. Available at: <> .

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Why Are Urinary Tract Infections Common In Older Adults

Seniors are more vulnerable for many reasons, including their overall susceptibility to infections due to a weakened immune system.

As you get older, your immune response changes its part of normal aging, explains Anna Dowd, APN, a gerontological nurse practitioner in the greater Chicago area.

According to the National Institutes of Health , the following conditions make older individuals more susceptible to UTIs:

  • Urine retention
  • Use of a urinary catheter
  • Bowel incontinence
  • Urinary incontinence
  • Surgery of any area around the bladder

People with incontinence are at an increased risk for UTIs because of the close contact that adult briefs and other incontinence products have with their skin. While these products can help contain messes and prevent embarrassment associated with accidents, they can also introduce bacteria into the urethra. Women are more prone to UTIs because the female urethra is much shorter, allowing bacteria to travel to the bladder more easily.

Who Is Affected By Utis And How Are They Treated

Urinary Tract Infection (UTI): Overview and More

Women are more commonly affected by them than men. Around half of women will need treatment for at least one UTI during their lifetime.

If treated with the right antibiotics, UTIs normally cause no further problems and the infection soon passes. Though complications are uncommon, they can be serious and include kidney damage and blood poisoning, which can be fatal.

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How Can I Prevent A Uti

The No. 1 way to prevent a UTI is to empty your bladder completely and often. Dr. Slopnick suggests urinating every few hours, whether you feel the need to go or not.

She also recommends these tried-and-true prevention strategies:

  • Drink water regularly. You dont need to overdo it, but drink to thirst. Your goal should be that your pee appears something like the color of pale straw.
  • Practice good genital and urinary hygiene, including wiping front to back and washing your hands.
  • Ask a healthcare provider about low-dose vaginal cream for postmenopausal women. This can help rejuvenate the vaginal skin and support the presence of good bacteria.
  • Consider taking a probiotic to encourage the growth of good bacteria.
  • Try cranberry supplements or 100% cranberry juice. This is recommended in the American Urological Association guidelines for women who experience frequent UTIs.
  • Consider taking D-Mannose, a supplement that sticks to bladder receptors that normally attract E. coli bacteria. Thats the bacteria that are usually responsible for UTIs.
  • Patient And Public Involvement

    This project was developed within a context of strong patient and public involvement already established within our research team, university, and trust. Two former patients aged 65 and older reviewed the protocol. Their input helped to refine the research question and to improve the protocol considerably. The dissemination plan targets a wide audience, including members of the public, patients, health professionals, and experts in the specialty through various channels available: written communication, events and conferences, networks and social media.

    Recommended Reading: What Is The Best Urinary Tract Infection Medicine

    Quality Assessment / Risk Of Bias

    Two review authors assessed the risk of bias of included studies independently, with any discrepancies being resolved by consensus, or through discussion with a third reviewer , if necessary. The risk of bias was assessed using a modified version of the assessment checklist developed by Downs and Black . Quality items that pertained to interventions and trial studies were removed as they were not deemed to be appropriate for the studies included in this review. An additional five quality items were added to the quality assessment to determine if studies described the criteria used for confusion, UTI and bacteriuria, and if their criteria for UTI and confusion were valid and reliable. Criteria for confusion were deemed valid and reliable if accepted criteria were utilised, including: the Confusion Assessment Method, the Organic Brain Syndrome Scale or the Diagnosis and Statistical Manual criteria . Similarly, criteria for UTI were deemed valid and reliable if established criteria for UTI were utilised, including: the McGeer Criteria, the revised McGeer Criteria, the Loeb Criteria, or the Revised Loeb Criteria . The modified checklist finally consisted of 14 quality items, grouped into: reporting, internal validity, external validity and criteria . The risk of bias for each quality item was reported as low risk of bias, high risk of bias, unclear risk of bias or not applicable.

    Table 2 Quality Assessment Criteria

    How Common Are Urine Infections

    Signs & Symptoms of Urinary Tract Infections | Dr Sudeep Singh Sachdeva

    Urine infections are much more common in women. This is because in women the urethra – the tube from the bladder that passes out urine – is shorter. Also it opens nearer the back passage than in men. Half of all women will have a urine infection that needs treating in their lifetime.

    Urine infections are less common in men. They are very uncommon in young and middle-aged men. They are more common in older men. They are more likely to occur in men who have to use a catheter. A catheter is a thin, flexible, hollow tube used to drain urine. Older men are more likely to need a catheter because of prostate problems, which become more common with age.

    Urine infections tend to become more common as you get older.

    Read Also: Why Do Cats Get Urinary Tract Infections

    What Are The Symptoms

    It may be hard to figure out if a loved one has a UTI or not, because they may not have the classic symptoms. This is because urinary problems, such as incontinence, may have similar symptoms related to another issue, making it more difficult to recognize.

    The classic, or common, symptoms of a UTI can include:

    • Burning while urinating
    • Frequent or urgent need to urinate
    • A feeling the bladder is not completely empty
    • Lower abdominal or pelvic pain

    More severe symptoms of a complicated UTI can include:

    A Pharmacist Can Help With Utis

    You can ask a pharmacist about treatments for a UTI. A pharmacist can:

    • offer advice on things that can help you get better
    • suggest the best painkiller to take
    • tell you if you need to see a GP about your symptoms

    Some pharmacies offer a UTI management service and can prescribe antibiotics if theyre needed.

    Read Also: Urinary Incontinence After Prostate Surgery

    Urinary Tract Infection Symptoms And Signs

    Symptoms of a urinary tract infection are similar in men, women, and children.

    • Early symptoms and signs are usually easy to recognize and primarily involve pain, discomfort, or burning when trying to urinate.
    • Accompanying this can be the sense that one needs to urinate urgently or the need for frequent urination . Even when there is a strong urge to urinate, you may pass only a small amount of urine.
    • The urine itself may appear bloody or cloudy. Men may feel pain in the rectum, while women may experience pain around the pubic bone.

    Causes Of Urinary Tract Infections

    UTIs in the Elderly: Signs, Symptoms and Treatments

    Urinary tract infections are usually caused by bacteria from poo entering the urinary tract.

    The bacteria enter through the tube that carries pee out of the body .

    Women have a shorter urethra than men. This means bacteria are more likely to reach the bladder or kidneys and cause an infection.

    Things that increase the risk of bacteria getting into the bladder include:

    • do not use scented soap

    • do not hold your pee in if you feel the urge to go

    • do not rush when going for a pee try to fully empty your bladder

    • do not wear tight, synthetic underwear, such as nylon

    • do not drink lots of alcoholic drinks, as they may irritate your bladder

    • do not have lots of sugary food or drinks, as they may encourage bacteria to grow

    • do not use condoms or a diaphragm or cap with spermicidal lube on them try non-spermicidal lube or a different type of contraception

    Read Also: Urinary Tract Infection Frequent Urination

    Bladder Infections In Females Vs Males

    Because bacteria can more easily reach the bladder in women, women are more prone to get bladder infections. For men it is more difficult to contract a UTI, than for women for basic anatomy reasons. However that doesnt mean it cant happen. Everyone should keep good hygiene and stay hydrated to help lower the risk of UTIs.

    Recommended Reading: Natural Ways To Control Overactive Bladder

    What Causes A Urinary Tract Infection

    The main cause of UTIs, at any age, is usually bacteria. Escherichia coli is the primary cause, but other organisms can also cause a UTI.

    In older adults who use catheters or live in a nursing home or other full-time care facility, bacteria such as Enterococci and Staphylococci are more common causes.

    Recommended Reading: What Does A Urinary Tract Infection Feel Like

    Senior Uti Do You Know The Symptoms

    Urinary tract infections, or UTIs, are the most common bacterial infection in older adults,affecting women more often than men.

    UTIs can typically be treated effectively with antibiotics once diagnosed.Unfortunately, not all UTIs are treated quickly, and some arent even identified, particularly in seniors.

    What is a UTI?

    A UTI is an infection in the urinary tract. The urinary tract includes the kidneys, bladder, ureters and the urethra which carries urine out of the body. They are most commonly caused by bacteria but can also be a fungal infection.

    A lower UTI is a common infection, affecting the lower part of the urinary tract, the urethra and urinary bladder. Infection of the urethra is urethritis while a bladder infection is cystitis. An upper UTI affects the kidneys.

    What causes a UTI?

    A typical bacterial UTI is caused by bacteria, often fecal bacteria, entering the urethra through the urethral opening where urine is released from the body. Usually, the body can fight off these bacteria and prevent infection. However, if the immune system is too weak, the bacteria multiply, causing infection.

    Fungal UTIs usually stem from fungus in the bloodstream. Fungal UTIs are relatively uncommon, impacting mainly those with illnesses that compromised their immune system.

    What are the symptoms of a UTI?

    When typical, healthy adults get a UTI, the symptoms are usually easy to identify, and the infection is simple to diagnose:

    If left untreated, a person may experience:

    Incontinence And Alzheimers Disease

    UTIs in the Elderly- What you need to know

    People in the later stages of Alzheimers disease often have problems with urinary incontinence. This can be a result of not realizing they need to urinate, forgetting to go to the bathroom, or not being able to find the toilet. To minimize the chance of accidents, the caregiver can:

    • Avoid giving drinks like caffeinated coffee, tea, and sodas, which may increase urination. But dont limit water.
    • Keep pathways clear and the bathroom clutter-free, with a light on at all times.
    • Make sure you provide regular bathroom breaks.
    • Supply underwear that is easy to get on and off.
    • Use absorbent underclothes for trips away from home.

    For more ways to deal with incontinence and other common medical problems in someone with Alzheimers, visit Alzheimers Disease: Common Medical Problems.

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    Summary Of The Evidence

    Following this review, it is evident that all of the studies which have explored the association between suspected UTI and confusion are methodologically flawed, due to poor case definition for UTI or confusion, or inadequate control of confounding factors introducing significant bias. Subsequently, no accurate conclusions about the association between UTI and confusion can be drawn. One study of acceptable quality shows an association between confusion and bacteriuria. However, this sample of patients in whom they tested bacteriuria and pyuria were patients already suspected of having a UTI, introducing a bias into their calculation . In summary, none of the 22 publications had sufficient methodological quality to enable valid conclusions.

    Things You Can Do Yourself

    To help ease symptoms of a urinary tract infection :

    • takeparacetamolup to 4 times a day to reduce pain and a high temperature for people with a UTI, paracetamol is usually recommended over NSAIDs such as ibuprofen or aspirin
    • you can give childrenliquid paracetamol
    • rest and drink enough fluids so you pass pale urine regularly during the day
    • avoid having sex

    Some people take cystitis sachets or cranberry drinks and products every day to prevent UTIs from happening, which may help. However, there’s no evidence they help ease symptoms or treat a UTI if the infection has already started.

    Recommended Reading: Can Toilet Paper Cause Urinary Tract Infection

    How Are Utis Treated In Seniors

    Fortunately, most seniors can recover from a urinary tract infection at home with an antibiotic. Older women who frequently develop UTIs may be given an estrogen cream to apply regularly to lower the likelihood of repeat infections. If a UTI turns into a kidney infection, hospitalization may be necessary.

    Urinary Incontinence In Men

    Figure 1 from CLINICAL PRACTICE. Urinary Tract Infections in Older Men ...

    Uncontrollable urination or urinary incontinence occurs in eleven to 34 percent of older men, but it is not just an age-related issue. Younger men can also experience incontinence due to health problems. Urinary incontinence also happens to women, but the biggest issue with incontinence in men is that they are less likely to speak with their doctors about it. This means that the statistics for men could actually be much higher in men that the current numbers indicate. Discussing the problem is the first step towards addressing the symptoms and finding a treatment.

    Urinary incontinence often results in the accidental leakage of urine from the body, so it can be uncomfortable and inconvenient. A man can feel a strong, sudden need to urinate just before losing a large amount of urine. Doctors refer to this as urgency incontinence. For some people, this condition keeps them from enjoying certain activities, including sports and exercise. It can also cause a lot of emotional distress as well.

    There are different types of urinary incontinence. The types of urinary incontinence men can experience include urgency incontinence, stress incontinence, functional incontinence, overflow urinary incontinence, and transient urinary incontinence.

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    Urine Infection In Older People

    In this series

    If you have a urine infection, you have germs in your bladder, kidneys or the tubes of your urinary system. Urine infections are more common in older people, and there is more likely to be an underlying cause.

    In this article

    Urine Infection in Older People

    In this article

    How Can Utis In The Elderly Be Prevented

    Once a UTI infection is gone, prevention should consist of maintaining a more set schedule. Some older people start a urination schedule, setting up alarms to remind themselves to urinate. Implementing better hygiene to keep the midsection area clean and dry is also key. Seniors should regularly wear and change loose, breathable cotton underwear that can be cleaned easily. A ritual of wiping from front to back when using the bathroom is also critical.

    Some urologists claim that there is an ingredient in cranberry juice that prevents bacteria, especially E coli, from adhering to the bladder wall. The ingredient is A-type proanthocyanidins or PACs. There is debate in the medical and healthcare communities as to whether there are enough PACs in cranberry juice to actually stop bacteria from grabbing on to the bladder wall. You could say that the theory has caused a healthy, sweet and sour debate! Essentially, all of these preventative measures mentioned boil down to one theme: better care.

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