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Kristin McNealus, DPT, MBA

What to Know about UTIs


Often, an injury to the neurological system can cause impairment of the bladder function. There are a number of issues that can arise, from a lack of coordination of sphincters or a lack of sensation of a full bladder. Whatever causes the impairment, the risk for urinary tract infections (UTI) increases. This is an infection that arises when bacteria get into the bladder.

As people age, the risk for UTIs also increases. There are a number of reasons for this. When women have less estrogen, more bacteria may grow in the vagina or urethra. Men may have a partial blockage of the urinary tract by an enlarged prostate. Elderly men and women also have a weakening of the bladder and pelvic floor muscles. This can cause urine retention by not completely emptying the bladder when voiding. Additionally, many people do not drink enough water, especially for the number of medications they take. And this dehydration can limit how much urine is produced.

The common symptoms of a UTI are painful urination, frequent urination, a foul odor, and urgency. However, there are other symptoms that may arise. Elderly people may experience confusion, agitation, hallucinations, or delirium. If you notice a change in mentation in your loved one, get them checked out. Other symptoms may include poor motor skills, a loss of coordination, dizziness, and falls. These lesser known symptoms could also be experienced by people who have had a stroke when a UTI develops. People who have had a neurological injury may also have an increase in spasticity or tone.

Be aware of these symptoms so treatment can start before someone falls, or before it leads to sepsis. The treatment is often a short course of antibiotics. Repeated use of antibiotics also has its own health risks, so preventing a UTI is the best. Be sure to stay well hydrated with water (sugary drinks and alcohol and increase the risk) and stay active! Exercise can help the pelvic floor muscle strength to promote full emptying of the bladder. If you are weak after an infection, a physical therapist can help your recovery as well.

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