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Thanks for contacting with your health concern
1. As you are not sexually active thus STIs are safely excluded. [even then make an appointment with your docctor]
PS. According to the rule of thumb: Frequency of sexual intercourse is the strongest predictor of recurrent
urinary tract infections in patients presenting with recurrent dysuria
2.
Asymptomatic bacteriuria and symptomatic UTIs in older women are commonly encountered in practice and since it is recurrent [3rd in 6 months] thus one has to exclude conditions which may impede urine flow like congenital urinary tract abnormalities, and inflammation.
3. according to the Journal of American Family Physician: Patients at risk of complicated urinary tract infections are best managed with
-broad-spectrum antibiotics initially,
- urine culture to guide subsequent therapy, and
- renal imaging studies if structural abnormalities are suspected.
4. Other predisposing factors which can be considered are any
immunosuppression, diabetes,
chronic kidney disease [CKD], being in a nursing home or hospital and since there is presence of blood,
consult a Urologist for differential diagnosis of the same [
bladder cancer or interstitial cystitis]
5. Patients with recurrent UTIs should be counseled about risk factors such as
spermicide use, frequent sexual intercourse, and new sex partners, as well as about preventive measures, like
i. Cranberrry juice has shown benefits in women with recurrent UTI [daily intake of 150 - 750 ml]
ii. Several studies have demonstrated the effectiveness of using topical estrogen (0.5 mg of estriol vaginal cream nightly for two weeks, then twice weekly for eight months), but adverse effects are common.