Asymptomatic bacteriuria tied to decreased bladder contractility and voiding efficiency

JAPAN: According to a study published in the World Journal of Urology, asymptomatic bacteriuria was reported in more than 20% of men who had non-neurogenic lower urinary tract symptoms and was linked to impaired bladder contractility and decreased bladder voiding efficiency.

In clinical practice, asymptomatic bacteriuria is highly prevalent, and its incidence rises with aging. The majority of patients with asymptomatic bacteriuria never experience symptomatic urinary tract infections and therefore don't suffer any negative effects as a result. Asymptomatic bacteriuria is hypothesized to be more likely as a result of several circumstances.

Investigating the prevalence of asymptomatic bacteriuria (ASB) in middle-aged and older men with non-neurogenic lower urinary tract symptoms (LUTS) and elucidating the urodynamic variables associated with ASB were the study's main objectives.

The clinical information of men with LUTS who underwent urine culture investigation, LUTS severity rating, and urodynamic studies was retrospectively examined by the researchers. According to the presence or absence of ASB, the patients were divided into two groups (ASB Plus LUTS and LUTS-only). Receiver-operating characteristic (ROC) curve, binomial logistic regression, and univariate analyses were used to evaluate the patient characteristics and urodynamic variables associated with the development of asymptomatic bacteriuria.

Key findings of the research:

• 93 males (21.1%) out of 440 had ASB.
• The ASB + LUTS group showed a substantial reduction in voiding function parameters as maximum flow rate, post-void residual urine volume, bladder voiding efficiency (BVE), and bladder contractility index (BCI), however bladder outlet obstruction index did not differ between the groups.
• According to a binomial logistic regression analysis, ASB was strongly linked with the presence of diabetes, poorer BCI, and lower BVE.
• With a sensitivity of 84% and a specificity of 83%, ROC analysis also determined that 55% was the ideal BVE cutoff value for the detection of ASB.

The authors came to the conclusion that bladder voiding efficiency could accurately and specifically predict the existence of asymptomatic bacteriuria.

Asymptomatic bacteriuria was associated with decreased bladder contractility and decreased bladder voiding efficiency.

REFERENCE

Ishida, S., Matsukawa, Y., Yuba, T. et al. Urodynamic risk factors of asymptomatic bacteriuria in men with non-neurogenic lower urinary tract symptoms. World J Urol (2022). https://doi.org/10.1007/s00345-022-04194-x