Comparison of the diagnostic yield of routine versus indicated flowmetry, ultrasound and cystoscopy in women with recurrent urinary tract infections.

Autor: Pat JJ; Department of General Practice and Elderly Care Medicine, University Medical Centre Groningen, Groningen, The Netherlands. j.j.pat@isala.nl.; Department of Urology, Isala Clinics, Zwolle, The Netherlands. j.j.pat@isala.nl., Steffens MG; Department of Urology, Isala Clinics, Zwolle, The Netherlands., Witte LPW; Department of Urology, Isala Clinics, Zwolle, The Netherlands., Marcelissen TAT; Department of Urology, Maastricht University Medical Centre, Maastricht, The Netherlands., Blanker MH; Department of General Practice and Elderly Care Medicine, University Medical Centre Groningen, Groningen, The Netherlands.
Jazyk: angličtina
Zdroj: International urogynecology journal [Int Urogynecol J] 2022 Aug; Vol. 33 (8), pp. 2283-2289. Date of Electronic Publication: 2021 Jun 14.
DOI: 10.1007/s00192-021-04871-2
Abstrakt: Introduction and Hypothesis: To quantify and compare the outcomes of routine vs. urologist-requested diagnostic testing for recurrent urinary tract infections (rUTI).
Methods: A retrospective cohort study of patients with rUTI referred to a large non-academic teaching hospital between 2016 and 2018 (Hospital A) and a university hospital between 2014 and 2016 (Hospital B). Electronic medical records were reviewed for baseline and diagnostic data. Women underwent the following assessments routinely: urinalysis, voiding diary, flowmetry in Hospital A and urinalysis, voiding diary, flowmetry, ultrasound, abdominal x-ray and cystoscopy in Hospital B. All other diagnostics were performed by indication in each hospital.
Results: We included 295 women from Hospital A and 298 from Hospital B, among whom the mean age (57.6 years) and mean UTI frequency (5.6/year) were comparable, though more were postmenopausal in Hospital A. We identified abnormalities by flowmetry or post-void residual volumes in 134 patients (Hospital A: 79; Hospital B: 55), cystoscopy in 14 patients (Hospital A: 6; Hospital B: 8) and ultrasound in 42 patients (Hospital A: 16; Hospital B: 26), but these differences were not significant. Diagnostics altered treatment in 117 patients (e.g., pelvic floor muscle training, referral to another specialist, surgical intervention), mostly due to flowmetry and post-void residual volume measurement. The retrospective design and absence of follow-up data limit these results.
Conclusions: The routine use of cystoscopy and ultrasound in female patients with rUTIs should not be recommended as they yield few abnormalities and lead to additional costs.
(© 2021. The Author(s).)
Databáze: MEDLINE
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