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Asymptomatic bacteriuria: Who need to be treated?

Asymptomatic bacteriuria: Who need to be treated?
FB Dr Soarawee
Soarawee Weerasopone, MD

Minimally Invasive Uro-Oncologist
Royal Phnom Penh hospital, Kingdom of Cambodia

Asymptomatic bacteriuria issue which is commonly the issue more likely in a pregnant woman have driving almost gynecologist annoyed. After they found out this problem the patients are always transferred to Urology office. However, this kind of problem is not more likely to be occurred only for pregnancy women, by the way, we will dive out this problem “Asymptomatic bacteriuria” in every aspect of it.

Before we dive deeper, first of all you must fully understand the definition of this condition. Asymptomatic bacteriuria is a combination words between “Asymptomatic” and “Bacteriuria”

  • Asymptomatic – means no any urinary symptoms at all for example – No painful with urination, no urinary frequency, and no suprapubic discomfort.
  • Bacteriuria – means a state of bacteria positive in urine culture.

In conclusion, asymptomatic bacteriuria means a state of positive bacteria colonized in urine without any urinary symptoms. This condition can be occurred in both male and female but more likely in female.

Once patient has been diagnosed with this condition, the rolling of the imaging of urinary tract system shall clarify whether there is no sign of an abnormal urinary tract anatomy involved.

The treatment is another challenging stuff whether we should treat or no treat on this condition? Because most of the patients seems to be won’t get any benefit from antibiotic treatment. Nevertheless, it has increased risk of drug-resistant bacteria.

But we still having for 2 specifically conditions which really need to be treated with antibiotic therapy

Asymptomatic bacteriuria: Who need to be treated?
There’s a confirmed reports that Asymptomatic bacteriuria significantly increases preterm labor incidence, increases risk of kidney infection.

2 Specific Asymptomatic bacteriuria condition which need to be treated.

  1. Pregnancy
    • There’s a confirmed reports that Asymptomatic bacteriuria significantly increases preterm labor incidence, increases risk of kidney infection
  2. Patients who planned to do urologic procedure
    • Urologic procedure itself may introduce a minor mucosal bleeding which can leads to symptomatic urinary tract infection afterward.
Asymptomatic bacteriuria: Who need to be treated?
Urologic procedure itself may introduce a minor mucosal bleeding which can leads to symptomatic urinary tract infection afterward.

For the cases that didn’t need any treatment, we’ll stick the following strategy

  • Regular follow up at the office with simple urine examination
  • If the simple urine examination shows positive inflammation cells, then we follow by the urine culture again.
Asymptomatic bacteriuria: Who need to be treated?

Asymptomatic bacteriuria is very sensitive issue which needs good doctor-patient relationship to maximize the treatment outcomes. If you have any question, talk to your trusted urologist or it would be my pleasure if you text me. See ya!

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