New avenue of diagnostic stewardship: procedural stewardship for recurrent urinary tract infections in female patients
Abstract Introduction: Societal guidelines offer a weak recommendation to perform cystoscopy for female patients with recurrent urinary tract infections (rUTI) of advanced age and/or with high-risk features. These guidelines lack the support of robust data and are instead based on expert opinion....
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2023-01-01
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| Series: | Antimicrobial Stewardship & Healthcare Epidemiology |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2732494X23005077/type/journal_article |
| _version_ | 1797394332973531136 |
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| author | Tanner D. Corse Linda Dayan Rahmani Hunter L. Hasley Katherine Kim Robert Harrison Debra L. Fromer |
| author_facet | Tanner D. Corse Linda Dayan Rahmani Hunter L. Hasley Katherine Kim Robert Harrison Debra L. Fromer |
| author_sort | Tanner D. Corse |
| collection | DOAJ |
| description |
Abstract
Introduction:
Societal guidelines offer a weak recommendation to perform cystoscopy for female patients with recurrent urinary tract infections (rUTI) of advanced age and/or with high-risk features. These guidelines lack the support of robust data and are instead based on expert opinion. In this retrospective cohort study, we aim to determine the utility of cystoscopy in patients with and without high-risk features for rUTI.
Materials and methods:
We identified 476 women who underwent cystoscopy for the evaluation of rUTI at a single tertiary academic medical center from May 1, 2015 and March 15, 2021. Patients were excluded if they had a competing indication for cystoscopy. Risk factors, demographic information, cystoscopic findings, and patient outcomes were analyzed.
Results:
192 (41.1%) were classified as having complicated UTI. We identified six patients (1.3%) with findings that prompted management to significantly impact patient outcomes. All six patients had high-risk features. 14 patients (3.0%) were found to have mucosal abnormalities prompting biopsy, three of which required general anesthesia. All 14 biopsies were ultimately benign.
Conclusions:
Our findings demonstrate a low diagnostic yield and increased risk exposure for women undergoing cystoscopy for the evaluation of complicated rUTI. Additionally, our observations support prior studies indicating that cystoscopy has limited utility in the evaluation of rUTI without high-risk features.
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| first_indexed | 2024-03-09T00:18:08Z |
| format | Article |
| id | doaj.art-3bec4a8e40e146b685e97b21fd11efdd |
| institution | Directory Open Access Journal |
| issn | 2732-494X |
| language | English |
| last_indexed | 2024-03-09T00:18:08Z |
| publishDate | 2023-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Antimicrobial Stewardship & Healthcare Epidemiology |
| spelling | doaj.art-3bec4a8e40e146b685e97b21fd11efdd2023-12-12T07:28:17ZengCambridge University PressAntimicrobial Stewardship & Healthcare Epidemiology2732-494X2023-01-01310.1017/ash.2023.507New avenue of diagnostic stewardship: procedural stewardship for recurrent urinary tract infections in female patientsTanner D. Corse0https://orcid.org/0000-0001-7802-3999Linda Dayan Rahmani1Hunter L. Hasley2https://orcid.org/0000-0002-2539-3328Katherine Kim3Robert Harrison4https://orcid.org/0000-0001-6592-6937Debra L. Fromer5Department of Urology, Hackensack Meridian School of Medicine, Nutley, NJ, USA Department of Urology, Hackensack University Medical Center, Hackensack, NJ, USADepartment of Urology, Hackensack Meridian School of Medicine, Nutley, NJ, USADepartment of Urology, Hackensack Meridian School of Medicine, Nutley, NJ, USADepartment of Urology, Hackensack Meridian School of Medicine, Nutley, NJ, USADepartment of Urology, Hackensack University Medical Center, Hackensack, NJ, USADepartment of Urology, Hackensack Meridian School of Medicine, Nutley, NJ, USA Department of Urology, Hackensack University Medical Center, Hackensack, NJ, USA Abstract Introduction: Societal guidelines offer a weak recommendation to perform cystoscopy for female patients with recurrent urinary tract infections (rUTI) of advanced age and/or with high-risk features. These guidelines lack the support of robust data and are instead based on expert opinion. In this retrospective cohort study, we aim to determine the utility of cystoscopy in patients with and without high-risk features for rUTI. Materials and methods: We identified 476 women who underwent cystoscopy for the evaluation of rUTI at a single tertiary academic medical center from May 1, 2015 and March 15, 2021. Patients were excluded if they had a competing indication for cystoscopy. Risk factors, demographic information, cystoscopic findings, and patient outcomes were analyzed. Results: 192 (41.1%) were classified as having complicated UTI. We identified six patients (1.3%) with findings that prompted management to significantly impact patient outcomes. All six patients had high-risk features. 14 patients (3.0%) were found to have mucosal abnormalities prompting biopsy, three of which required general anesthesia. All 14 biopsies were ultimately benign. Conclusions: Our findings demonstrate a low diagnostic yield and increased risk exposure for women undergoing cystoscopy for the evaluation of complicated rUTI. Additionally, our observations support prior studies indicating that cystoscopy has limited utility in the evaluation of rUTI without high-risk features. https://www.cambridge.org/core/product/identifier/S2732494X23005077/type/journal_article |
| spellingShingle | Tanner D. Corse Linda Dayan Rahmani Hunter L. Hasley Katherine Kim Robert Harrison Debra L. Fromer New avenue of diagnostic stewardship: procedural stewardship for recurrent urinary tract infections in female patients Antimicrobial Stewardship & Healthcare Epidemiology |
| title | New avenue of diagnostic stewardship: procedural stewardship for recurrent urinary tract infections in female patients |
| title_full | New avenue of diagnostic stewardship: procedural stewardship for recurrent urinary tract infections in female patients |
| title_fullStr | New avenue of diagnostic stewardship: procedural stewardship for recurrent urinary tract infections in female patients |
| title_full_unstemmed | New avenue of diagnostic stewardship: procedural stewardship for recurrent urinary tract infections in female patients |
| title_short | New avenue of diagnostic stewardship: procedural stewardship for recurrent urinary tract infections in female patients |
| title_sort | new avenue of diagnostic stewardship procedural stewardship for recurrent urinary tract infections in female patients |
| url | https://www.cambridge.org/core/product/identifier/S2732494X23005077/type/journal_article |
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