TY - JOUR
T1 - Comparison of the diagnostic yield of routine versus indicated flowmetry, ultrasound and cystoscopy in women with recurrent urinary tract infections
AU - Pat, Jorik J.
AU - Steffens, Martijn G.
AU - Witte, Lambertus P. W.
AU - Marcelissen, Tom A. T.
AU - Blanker, Marco H.
N1 - Funding Information:
We thank Dr. Robert Sykes (www.doctored.org.uk) for providing editorial services. All authors contributed to the design of the study. JJP and TAT collected the data. JJP performed the data analysis and drafted the manuscript. MGS, LPW, MHB and TAT critically revised the manuscript. All authors approved the final version of the manuscript.
Publisher Copyright:
© 2021, The Author(s).
PY - 2022/8
Y1 - 2022/8
N2 - 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.
AB - 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.
KW - Urinary tract infection
KW - Diagnostics
KW - Routine
KW - Cystoscopy
KW - Ultrasound
KW - Flowmetry
KW - INTRAVENOUS UROGRAPHY
KW - YOUNG-WOMEN
U2 - 10.1007/s00192-021-04871-2
DO - 10.1007/s00192-021-04871-2
M3 - Article
C2 - 34125244
SN - 0937-3462
VL - 33
SP - 2283
EP - 2289
JO - International Urogynecology Journal
JF - International Urogynecology Journal
IS - 8
ER -