Recurrent urinary tract infections in men: a role for aberrant bacterial forms?

We studied 11 infected, asymptomatic elderly men who had experienced recurrent urinary tract infections classified as bacterial relapse. These men did not have ileal loop bladders, urethral catheters, suprapubic catheters, or condom drainage. We had to process more than 1,000 urines from men attending the urology clinic to identify the 11 study patients. A positive antibody-coated bacteria immunofluorescence test was detected on the urinary sediments of each of these men. This selective study group was subjected to excretory urography and a 2-week course of antibiotics, in accordance with the results of in vaitro susceptibility tests. Two patients experienced a "cure." Recurrences developed in eight patients (six relapses, two reinfections), and in one patient a superinfection emerged. No pathogenetic role could be attributed to aberrant bacterial forms in this elderly population of asymptomatic men with recurrent, invasive urinary tract infections.