Flexible cystoscopy helps find targeted care in recurrent urinary tract infections: Study

Texas: As an office diagnostic technique, flexible cystoscopy can give useful information about the underlying etiology of recurrent urinary tract infections (RUTIs) and enable targeted care in postmenopausal women, says an article published in Urology.

Recurrent urinary tract infections are characterized as "at least three UTIs each year or two UTIs in the past six months." It is a prevalent condition among women under the age of 65, with a one-in-1,000 chance of developing it. As a result, Janett Ordonez and colleagues undertook this research to examine the findings of office flexible cystoscopy in the evaluation and therapy of postmenopausal women with recurring urinary tract infections.

For this study, an independent researcher retrospectively examined flexible cystoscopy (FC) results and associated treatment choices over three consecutive years in an IRB-approved, prospectively kept database of women treated for RUTIs at a tertiary care facility. Demographic information, UTI history, hormone replacement therapy (HRT), diabetes history, prior urological surgeries, coital antibiotic prophylaxis use, sexual activity, urine culture results, antibiotic resistance/allergies, cystoscopy, and treatment plan were all reviewed in the electronic medical record (EMR).

The key findings of this study were as follows:

1. A flexible office cystoscopy was performed on 113 postmenopausal women in a row between 2017 and 2019, the majority of whom were Caucasian, to complete their RUTI assessment.

2. In 84 women, or 74%, the results of the cystoscopy were abnormal.

3. Trigonitis observations were among the aberrant findings seen more frequently overall during cystoscopy each year. Trigonitis was also the most frequent cystoscopy finding (67%).

4. Both post-evaluation treatment plans and further abnormal cystoscopy findings did not substantially change over time.

5. The treatment of RUTIs involves the excision of exposed urethral/bladder mesh and/or electrofulguration of regions affected by chronic cystitis.

In conclusion, the findings of this study clearly state the usefulness of flexible cystoscopy in the detection and elaboration of the etiology of underlying RUTIs diseases and can be advised by physicians more often.

Reference: 

Ordonez, J., Christie, A. L., & Zimmern, P. E. (2022). Role of Flexible Cystoscopy in the Management of Postmenopausal Women with Recurrent Urinary Tract Infections. In Urology. Elsevier BV. https://doi.org/10.1016/j.urology.2022.07.040