A 57yo woman presents with dysuria, frequency and urinary incontinence. She complains of
dyspareunia. Urine culture has been done and is sterile. What is the most appropriate step?
a. Oral antibiotics
b. Topical antibiotics
c. Topical estrogen
d. Oral estrogen
e. Oral antibiotics and topical estrogen
answer: C, sterile culture means no UTI
Dysuria occurs in women with atrophic vaginitis because of urine contact
with the inflamed atrophic tissues themselves or because of the
increased incidence of urinary tract infections in these women. Atrophic
vaginitis is a common disorder, affecting from 20 to 30 percent of
postmenopausal women. Decreased vaginal discharge, vaginal tenderness
and dyspareunia are common in women with atrophic vaginitis. Women may
also have bloody vaginal spotting, especially after intercourse.
TTT estrogen cream
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