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

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.