Female urodynamics and lower urinary tract infection

Area of Science:

• Urology
• Gynecology
• Medical Microbiology

Background:

• Urinary tract infections (UTIs) are common, and asymptomatic bacteriuria can be present before medical procedures.
• Urodynamic investigations, such as cystometry, are used to assess bladder function.
• The relationship between asymptomatic bacteriuria and urodynamic findings requires clarification.

Purpose of the Study:

• To determine the incidence of unsuspected UTI before cystometry.
• To evaluate if asymptomatic bacteriuria impacts cystometry results.
• To assess the incidence of iatrogenic UTIs after cystometry.

Main Methods:

• A prospective study involving 117 women undergoing urodynamic investigations.
• Urine samples were collected before and after cystometry.
• Data on patient demographics and urodynamic diagnoses were recorded.

Main Results:

• 10.3% of patients had asymptomatic bacteriuria before cystometry, significantly associated with age and sensory urgency.
• Asymptomatic bacteriuria did not significantly affect detrusor instability or stress incontinence.
• 19.6% of patients developed a UTI after the procedure, with no significant association with baseline factors.

Conclusions:

• Universal screening for bacteriuria before urodynamic investigation is not supported by these findings.
• Asymptomatic bacteriuria only influenced urodynamic outcomes in patients with sensory urgency.
• Screening and treatment for bacteriuria should be individualized, particularly for older women with irritative bladder symptoms. Patient counseling regarding post-procedure UTI risk is advised.