Baseline Characteristics, Evaluation, and Management of Women With Complaints of Recurrent Urinary Tract Infections.

Journal Article (Journal Article)

Objective

The aims of this study were to determine the proportion of women presenting for recurrent urinary tract infections (UTIs) who met the diagnostic criteria (culture-proven UTI ≥3 in 1 year or ≥2 in 6 months) and to assess advanced testing utilization, preventive therapy use, and risk factors.

Methods

This is a retrospective chart review of women seen as new urogynecology consults for recurrent UTI (rUTI) between April 1, 2017, and April 1, 2018, followed through April 1, 2019. Exclusion criteria included catheter use, cancer treatment within 2 years, and prior organ transplant, urinary diversion, conduit, or bladder augmentation.

Results

Of 600 women, 71% had follow-up with a median of 179 days. Urinary tract infection symptoms included frequency (50%), dysuria (46%), urgency (43%), and malodorous urine (7%). One third met the rUTI diagnostic criteria. Two hundred thirty-four (39%) underwent advanced testing, and 9% (21/234) of women who underwent advanced testing had a change in clinical care. Preventive therapy use increased after consultation (P < 0.001), with vaginal estrogen (47%) being most common. Compared with women not meeting the rUTI criteria, women meeting the rUTI criteria were more likely to be older (adjusted odds ratio [aOR], 1.03/year; 95% confidence interval [CI], 1.02-1.04), have a prior history of gynecologic cancer (aOR, 4.07; 95% CI, 1.02-16.25), or report UTI symptoms of dysuria (aOR, 2.27; 95% CI, 1.57-3.27), or malodorous urine (aOR, 2.96; 95% CI, 1.47-5.94) and, while equally likely to be receiving preventive treatment prior to consultation, were more likely after consultation (OR, 3.06; 95% CI, 2.05-4.55).

Discussion

Thirty-seven percent of women seen for rUTI met the diagnostic criteria. Advanced imaging rarely changed care. Education about diagnostic criteria and preventive therapy is warranted.

Full Text

Duke Authors

Cited Authors

  • Dieter, AA; Mueller, MG; Andy, UU; Kirby, AC; Dwarica, DS; Amundsen, CL; Gregory, WT; Desai, S; Clayton, L; Squires, NA; Allen, A; Casper, KP; Murphy, MJ; Shepherd, JP; Developed by the AUGS Junior Faculty Research Network,

Published Date

  • May 1, 2021

Published In

Volume / Issue

  • 27 / 5

Start / End Page

  • 275 - 280

PubMed ID

  • 33909600

Electronic International Standard Serial Number (EISSN)

  • 2154-4212

International Standard Serial Number (ISSN)

  • 2151-8378

Digital Object Identifier (DOI)

  • 10.1097/spv.0000000000001065

Language

  • eng