Urinary Abnormalities in Elderly Patients After COVID-19 - Urology

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In addressing your concerns regarding your father's urinary abnormalities following his COVID-19 diagnosis, it's essential to consider several factors that could be contributing to his symptoms. Given that he is 91 years old and has a history of benign prostatic hyperplasia (BPH), the urinary changes you describe—reduced urine output, dark-colored urine, and nocturia (increased urination at night)—are noteworthy and warrant careful evaluation.

Firstly, the color of urine can be influenced by various factors, including hydration status, dietary intake, and potential underlying medical conditions. The tea-colored urine you mentioned could indicate the presence of blood (hematuria) or concentrated urine due to dehydration. Even though your father is drinking 1800-2000 cc of water daily, factors such as his age, kidney function, and the effects of medications (including those for COVID-19) can impact how well his body is processing fluids.

The fact that his urine output is concentrated at night and minimal during the day could suggest a few possibilities. One consideration is that older adults often experience changes in their bladder function and may have a reduced ability to sense the need to urinate during the day. Additionally, the installation of a urinary catheter may have altered his normal urinary patterns, especially if he had been experiencing urinary retention due to BPH prior to catheterization.

Regarding your concerns about kidney inflammation or acute kidney injury, it is reassuring that blood tests indicated normal kidney function and white blood cell counts. However, persistent changes in urinary patterns, especially in an elderly patient, should not be overlooked. It is important to monitor for any additional symptoms such as swelling, changes in appetite, or fatigue, which could indicate worsening kidney function or other systemic issues.

Given the complexity of your father's situation, it would be prudent to consult a specialist. A urologist would be well-equipped to evaluate his urinary symptoms in the context of his BPH and recent COVID-19 infection. They can perform further assessments, including a urinalysis to check for signs of infection or blood, and possibly imaging studies to assess the urinary tract and kidneys.

Additionally, if you notice any signs of confusion, increased fatigue, or changes in his overall health, it may be necessary to seek immediate medical attention. These could be signs of dehydration or other complications that require prompt intervention.

In summary, while the initial evaluation by the emergency department was reassuring, ongoing monitoring of your father's urinary symptoms is crucial. Consulting a urologist will provide a more comprehensive understanding of his urinary issues and help determine the best course of action. It is always better to err on the side of caution, especially in elderly patients with complex medical histories.