Korean J Urol.  2010 Sep;51(9):625-630.

Prevalence and Treatment Efficacy of Genitourinary Mycoplasmas in Women with Overactive Bladder Symptoms

• Lee YS
• Kim JY
• Kim JC
• Park WH
• Choo MS
• Lee KS

Abstract

PURPOSE
To evaluate the incidence of genitourinary mycoplasmas and the efficacy of antibiotics in women with overactive bladder (OAB) symptoms.
MATERIALS AND METHODS
Women with OAB symptoms (micturition > or =8/24 hours and urgency > or =1/24 hours) for > or =3 months were screened for Mycoplasma hominis (M. hominis), Ureaplasma urealyticum (U. urealyticum), and Chlamydia trachomatis (C. trachomatis). Specimens from urethral and cervical vaginal swabs were examined for M. hominis and U. urealyticum by using the Mycoplasma IST2 kit and for C. trachomatis by using PCR. Women with positive results were treated with a 1 g dose of azithromycin. Persistent infection was treated with doxycycline. Changes in a 3-day bladder diary, Patient Perception of Bladder Condition (PPBC), and International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) were evaluated 4 weeks after negative conversion. Patient satisfaction was assessed.
RESULTS
Of 84 women screened, 42.8% were positive (U. urealyticum, 40.5%; M. hominis, 7.1%; C. trachomatis, 3.6%; two organisms, 8.3%). After treatment, 82.7% obtained negative conversion, and their median number of micturition episodes decreased from 10.6/24 hours to 8.1/24 hours (p=0.002). PPBC and domain scores of the ICIQ-FLUTS (filling and quality of life) significantly improved. About 87.5% women with negative conversion were satisfied with the treatment.
CONCLUSIONS
Considering diagnostic tests and treatment for genitourinary mycoplasmas might be beneficial before invasive workup or treatment in women with OAB symptoms.

Keyword

Chlamydia trachomatis; Mycoplasma hominis; Overactive urinary bladder; Ureaplasma urealyticum

MeSH Terms

Anti-Bacterial Agents
Azithromycin
Chlamydia trachomatis
Diagnostic Tests, Routine
Doxycycline
Female
Humans
Incidence
Lower Urinary Tract Symptoms
Mycoplasma
Mycoplasma hominis
Patient Satisfaction
Polymerase Chain Reaction
Prevalence
Treatment Outcome
Ureaplasma urealyticum
Urinary Bladder
Urinary Bladder, Overactive
Urination
Anti-Bacterial Agents
Azithromycin
Doxycycline

Figure

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  FIG. 1 Participant flow (n=84). a: identical treatment for the women's sexual partners, condom use during study period, b: after 2 weeks of treatment, from the previous infected site either urethra and/or cervical vagina. PCR: polymerase chain reaction.

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  FIG. 2 Changes in International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms after obtaining negative conversion (n=24). FS: filling sum, VS: voiding sum, IS: incontinence sum, Sex: sexual function, QoL: quality of life.

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