Postmenopausal Women and Urinary Tract Infection: A Literature Narrative Review

Abstract

Urinary tract infection (UTI) is a serious matter of concern worldwide. Urinary tract infections affect women more than men and are caused by normal bacterial flora that enters the urinary tract via urethra from bowel, vagina, or perineum. Postmenopausal women are more prone to developing symptomatic UTI due to estrogen deficiency as a leading factor. In a study conducted by Dason, Dason & Kapoor, the incidence of single and recurrent UTIs was 27% and 3% respectively. Recurrent infection was mostly a result of bacterial re-infection or persistence. Gram negative bacteria such as- E.coli and Klebsiella spp. have been reported to be the most common UTI causing organisms. E. coli causes around 70-95% of upper and lower UTI and is the cause for 80-85% of community-acquired UTI, while Staphylococcus saprophyticus accounts for 5–10% of urinary tract infections. In very rare cases, UTI is caused by viral or fungal infections. The clinical presentation of UTI is different in postmenopausal elderly women compared with younger women. Symptoms like frequency, dysuria, hematuria, and fever are not reported by postmenopausal women, but they are likely to report flank pain. Postmenopausal women are also affected by recurrent UTI, which is defined as ≥3 UTI per year or ≥2 urinary tract infection per half year. Increased mortality rates go hand in hand with bacteriuria in elderly women; though bacteriuria is mostly asymptomatic and does not cause death; this is a major concern. The aim of this paper is to conduct a narrative review of UTI in postmenopausal women to reach a better understanding of this problem.