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Pelvic floor dysfunction is not a risk factor for febrile urinary tract infection in adults
Cees van Nieuwkoop1, Petra J Voorham-van der Zalm, Anne-Marike van Laar
1Department of Infectious Diseases, Leiden University Medical Center, Leiden, the Netherlands. c.van_nieuwkoop@lumc.nl
Insights
Pelvic floor dysfunction (PFD) is common in adults but not a risk factor for febrile urinary tract infections (UTIs). This study found no significant link between PFD and developing a UTI.
Area of Science:
- Urology
- Infectious Diseases
- Pelvic Health
Background:
- Urinary tract infections (UTIs) are common in adults, often prompting investigation for underlying urological issues.
- Pelvic floor dysfunction (PFD) is increasingly recognized for its potential role in adult UTI pathophysiology.
- Understanding the relationship between PFD and febrile UTI is crucial for effective patient management.
Purpose of the Study:
- To investigate whether pelvic floor dysfunction (PFD) is a risk factor for or a consequence of febrile urinary tract infections (UTIs) in adults.
- To assess the association between PFD and febrile UTI using a case-control study design.
Main Methods:
- A multicenter case-control study involving 26 primary care centers and 6 emergency departments.
- 153 adult patients presenting with febrile UTI (cases) and 100 controls without UTI or fever were recruited.
- Pelvic floor function was assessed using the validated Pelvic Floor Inventories Leiden (PelFIs) questionnaire.
Main Results:
- The prevalence of PFD was similar between febrile UTI cases (21%) and controls (23%), with an odds ratio of 0.9 (95% CI, 0.4-1.78).
- Multivariate analysis identified comorbidity (OR 4.9) and a history of UTI (OR 2.5) as significant risk factors for febrile UTI, but not PFD (OR 1.0).
- Within the UTI cases, PFD was not associated with bacteriuria but was inversely related to a history of UTI in the prior year (OR 0.2).
Conclusions:
- Pelvic floor dysfunction is prevalent in the adult population.
- PFD does not appear to be a significant risk factor for developing febrile urinary tract infections in adults.
- Further research may explore other factors contributing to febrile UTI in adults with PFD.
Objective:
To determine whether pelvic floor dysfunction (PFD) might be a risk factor for or consequence of febrile urinary tract infection (UTI), as UTI in adults is a common infection in which an underlying urological abnormality is often considered, and as in children, PFD is also thought to have a pathophysiological role in adults with UTI.
Patients And Methods:
A multicentre case-control study was conducted at 26 primary-care centres and at six Emergency Departments of regional hospitals. Cases were consecutive patients aged > or =18 years, who presented with febrile UTI. Controls were randomly selected subjects who visited their general practitioner for reasons other than UTI or fever. A validated pelvic floor questionnaire (the Pelvic Floor Inventories Leiden, PelFIs) was used to assess pelvic floor function.
Results:
Between October 2006 and December 2007, 153 cases were included; of these, the completed questionnaires of 102 (response rate 67%) were compared to those of 100 of 110 (response rate 91%) controls. The median age of cases and controls was 65 and 58 years, respectively; 40% of cases and controls were men. The percentage of PelFIs outcomes consistent with PFD were comparable between cases and controls, at 21% vs 23%, respectively (odds ratio 0.9, 95% confidence interval, CI, 0.4-1.78). In the multivariate analysis, comorbidity (odds ratio 4.9, 95% CI 2.2-11.1) and a history of UTI (odds ratio 2.5, 95% CI 1.0-6.1) were independent significant risk factors for febrile UTI, whereas PFD was not (odds ratio 1.0, 0.5-2.2). Within the group of cases, PFD was not associated with bacteriuria during assessment of PelFIs (odds ratio 1.1, 95% CI 0.4-3.5) and inversely related to a history of UTI within the previous year (odds ratio 0.2, 0.1-0.9).
Conclusions:
PFD is common among adults but it does not seem to be a risk factor for febrile UTI.
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