Urogenit Tract Infect.  2019 Aug;14(2):46-54. 10.14777/uti.2019.14.2.46.

How Women Evaluate Syndromic Recurrent Urinary Tract Infections

• Kim WB
• Lee SW
• Lee KW
• Kim JM
• Kim YH
• Kim ME

• KMID: 2456609
• DOI: http://doi.org/10.14777/uti.2019.14.2.46

Abstract

PURPOSE
To investigate the clinical manifestations of patients with the principal complaint of syndromic recurrent urinary tract infection (UTI), correlate these symptoms with the results of urine cultures, and identify the characteristics that can be used to differentiate UTI from similar diseases.
MATERIALS AND METHODS
A total of 212 consecutive patients with syndromic recurrent UTIs over a 24 month period were evaluated. The major symptoms were recorded using the UTISA questionnaire and VAS. The patients were divided into group A (n=98; positive urine and urethral swab cultures) and group B (n=114; negative cultures), and the symptoms were compared. For group B, cystoscopy was used to diagnose 61 patients who complained of pain levels ≥6 on the VAS.
RESULTS
The proportion of patients with the classic symptoms of UTI (dysuria, urinary frequency, lower abdominal discomfort during bladder filling, and urgency) was similar in groups A and B. Significantly more patients complained of urethral pain in group B, and significantly fewer patients had gross hematuria, low back pain, a post-voiding sensation of residual urine, and general symptoms compared to group A. Of the 61 patients with a VAS ≥6, 29, 28, and four were diagnosed with bladder pain syndrome, interstitial cystitis, and urethral pain syndrome, respectively.
CONCLUSIONS
In patients with syndromic recurrent UTI, the classic symptoms were not sufficiently characteristic to allow bacterial cystitis to be differentiated from other bladder diseases. Diagnostic cystoscopy and VAS can assist in making a differential diagnosis in patients with non-bacterial syndromic recurrent UTIs.

Keyword

Urinary tract infections; Cystitis; Interstitial cystitis

MeSH Terms

Cystitis
Cystitis, Interstitial
Cystoscopy
Diagnosis, Differential
Female
Hematuria
Humans
Low Back Pain
Sensation
Urinary Bladder
Urinary Bladder Diseases
Urinary Tract Infections*
Urinary Tract*

Figure

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  Fig. 1. Flowchart used for inclusion in the study. UTI: urinary tract infection, OAB: overactive bladder, IC: interstitial cystitis.

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  Fig. 2. Urine culture-based classification of patients with syndromic recurrent urinary tract infections. VAS: visual analogue scale.

Reference

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