About this episode

This episode discusses prevention strategies for recurrent urinary tract infections in older women, focusing on the use of vaginal estrogen.

Contributor: Aaron Lessen, MD Educational Pearls: UTIs are commonly seen in older women We often see them taking long-term prophylactic antibiotics because of common recurrence. Around 20-30% of older women who develop a UTI have a recurrence due to either diagnostic failure, treatment failure or non-compliance with treatment. UTI signs and symptoms Burning sensation when urinating Strong urge to urinate Urinating often and passing small amounts of urine. Pelvic pain There are currently more guidelines and studies on treatments to prevent these recurrent UTIs in women that we can start in the Emergency Department. Vaginal estrogen has been shown to significantly reduce this issue of recurrence. Very simple prescriptions can be prescribed in the ED It has little systemic absorption and is generally very safe and effective. References Wells BA, De EJB, Visingardi J, Feustel PJ. IP15-36 IMPACT OF VAGINAL ESTROGEN ON SERIOUS ADVERSE OUTCOMES IN POSTMENOPAUSAL WOMEN WITH RECURRENT URINARY TRACT INFECTIONS: A RETROSPECTIVE STUDY. Journal of Urology [Internet]. 2025 May 1;213(5S):e778. Available from: https://doi.org/10.1097/01.JU.0001109984.67114.74.36 Ackerman AL, Bradley M, D'Anci…

People in this episode

Guest: Aaron Lessen, MD

Topics covered

• UTI prevention
• vaginal estrogen
• older women health
• emergency medicine
• antibiotic treatment

Keywords

• UTI
• vaginal estrogen
• recurrent infections
• older women
• emergency department
• antibiotics
• health guidelines

Mentioned in this episode

Organizations: Journal of Urology, AUA/CUA/SUFU, AUA/SUFU/AUGS

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