Midterm Follow-up of Electrofulguration for Vesicular Cystitis in Women with Recurrent Urinary Tract Infections.

IF 2.1 3区医学 Q2 UROLOGY & NEPHROLOGY Urology Pub Date : 2024-11-18 DOI:10.1016/j.urology.2024.10.072

Tze-Chen Chao, Alana L Christie, Feras Alhalabi, Philippe E Zimmern

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Abstract

Objectives: To report the midterm outcomes of women with symptomatic recurrent urinary tract infections (RUTI) with findings of vesicular cystitis (VC) on cystoscopy treated with bladder electrofulguration (EF), and to identify factors affecting successful treatment outcome.

Methods: Following IRB approval, a prospectively collected long-term database of women with RUTI and VC treated with EF was retrospectively reviewed. Patients were divided into two groups based on the associated presence of urinary obstruction ("obstructed group") or not. Follow-up included an office cystoscopy six months after EF. The primary outcome evaluated was rate of UTI recurrences over time.

Results: From 2010 to 2023, 50 women met all study criteria, with 94% being postmenopausal. Overall, the three-year UTI-free survival from repeat fulguration was 71.4% (95% CI, 54.4 to 83.0). Kaplan-Meier analysis showed that patients with obstruction had a higher 3-year survival of no UTI recurrence (40.3%; 95% CI: 18.2, 61.7) than patients without obstruction (20.8%; 95% CI: 6.2, 41.4], p = 0.0085).

Conclusions: Over two-thirds of women with VC and symptomatic UTI did not need a second EF or daily antibiotic prophylaxis after initial EF. Those with VC related to bladder outlet obstruction experienced less RUTIs and a longer time to a repeated EF.

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复发性尿路感染妇女膀胱炎电凝治疗的中期随访。

目的报告膀胱镜检查发现水泡性膀胱炎（VC）的无症状复发性尿路感染（RUTI）女性患者接受膀胱电凝（EF）治疗的中期疗效，并确定影响成功治疗结果的因素：方法：在获得 IRB 批准后，我们对前瞻性收集的长期数据库进行了回顾性审查，该数据库收录了接受 EF 治疗的 RUTI 和 VC 女性患者。根据是否伴有尿路梗阻（"梗阻组"）将患者分为两组。随访包括在超频治疗后六个月进行诊室膀胱镜检查。评估的主要结果是一段时间内UTI的复发率：从 2010 年到 2023 年，共有 50 名女性符合所有研究标准，其中 94% 为绝经后女性。总体而言，从重复充盈到无 UTI 的三年生存率为 71.4%（95% CI，54.4 至 83.0）。Kaplan-Meier 分析显示，有梗阻的患者 3 年无 UTI 复发的生存率（40.3%；95% CI：18.2，61.7）高于无梗阻的患者（20.8%；95% CI：6.2，41.4]，P = 0.0085）：超过三分之二的膀胱直肠癌和无症状UTI女性患者在首次超滤后无需进行第二次超滤或每日使用抗生素预防。与膀胱出口梗阻有关的输尿管梗阻患者发生尿路感染的次数较少，而重复使用超滤的时间较长。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Urology 医学-泌尿学与肾脏学

CiteScore

3.30

自引率

9.50%

发文量

716

审稿时长

59 days

期刊介绍： Urology is a monthly, peer–reviewed journal primarily for urologists, residents, interns, nephrologists, and other specialists interested in urology The mission of Urology®, the "Gold Journal," is to provide practical, timely, and relevant clinical and basic science information to physicians and researchers practicing the art of urology worldwide. Urology® publishes original articles relating to adult and pediatric clinical urology as well as to clinical and basic science research. Topics in Urology® include pediatrics, surgical oncology, radiology, pathology, erectile dysfunction, infertility, incontinence, transplantation, endourology, andrology, female urology, reconstructive surgery, and medical oncology, as well as relevant basic science issues. Special features include rapid communication of important timely issues, surgeon''s workshops, interesting case reports, surgical techniques, clinical and basic science review articles, guest editorials, letters to the editor, book reviews, and historical articles in urology.