Role of videourodynamics, imaging, and cystoscopy in patients with recurrent urinary tract infections: Should we throw in the kitchen sink?

Purpose:: Recurrent urinary tract infection (rUTI) remains a common outpatient problem with discordance and paucity of evidence for management. This study aims to evaluate the role of videourodynamics (VUD), additional imaging, and cystoscopy in the complete workup of these patients. Materials and M...

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Main Authors: G. Chan, F. Davidovic, J. Gani
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Continence Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772974524000279
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author G. Chan
F. Davidovic
J. Gani
author_facet G. Chan
F. Davidovic
J. Gani
author_sort G. Chan
collection DOAJ
description Purpose:: Recurrent urinary tract infection (rUTI) remains a common outpatient problem with discordance and paucity of evidence for management. This study aims to evaluate the role of videourodynamics (VUD), additional imaging, and cystoscopy in the complete workup of these patients. Materials and Methods:: A retrospective review was performed on 1421 consecutive patients referred for physician performed VUD. After exclusion criteria, 170 patients were included. Ethics approval was obtained, followed by data collection, and analysis of demographics, symptoms, cystoscopy results, imaging, and VUD parameters. Statistical analyses were performed with IBM SPSS Statistics Version 28. Statistical significance was defined by an alpha level of P ≤0.05. Results:: Overall, 117/170 (69%) had identifiable causes of rUTI identified on VUD. There was a statistically significant difference (p<0.001) in identifying a cause in those with voiding symptoms (93/114 = 82%) compared to those without (24/56 = 43%). Gender was not predictive of an identifiable cause on VUD (p=0.47). Neither was a neurogenic history (p=0.11), diabetes (p=0.97), or age (p=0.89). Additional imaging was not diagnostic for rUTI cause. No malignancy was identified on imaging or cystoscopy. Conclusion:: In patients with rUTI, VUD may be an important investigative step to find a possible underlying cause, but it is a scarce resource. As VUD has a higher detection rate in patients with voiding symptoms, by first screening for these patients on history, VUD can be used judiciously. Cystoscopy and additional imaging were not as helpful in identifying a target treatment plan for rUTI, when a VUD had already been done.
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spelling doaj-art-7a76c9c49ca449a480c4de65588ebfeb2025-08-20T01:56:42ZengElsevierContinence Reports2772-97452024-12-011210007310.1016/j.contre.2024.100073Role of videourodynamics, imaging, and cystoscopy in patients with recurrent urinary tract infections: Should we throw in the kitchen sink?G. Chan0F. Davidovic1J. Gani2University of Saskatchewan, College of Medicine, Saskatoon, Canada; University of Saskatchewan, Department of Surgery, Division of Urology, Saskatoon, Canada; University of Saskatchewan, Department of Obstetrics and Gynecology, Saskatoon, Canada; Correspondence to: University of Saskatchewan, College of Medicine, 105 Administration Pl, Saskatoon, SK S7N 5A2, Canada.University of Manitoba, Department of Surgery, Division of Urology, Winnipeg, CanadaAustin Health, Department of Urology, University of Melbourne, Australia; Western Health, Department of Urology, University of Melbourne, AustraliaPurpose:: Recurrent urinary tract infection (rUTI) remains a common outpatient problem with discordance and paucity of evidence for management. This study aims to evaluate the role of videourodynamics (VUD), additional imaging, and cystoscopy in the complete workup of these patients. Materials and Methods:: A retrospective review was performed on 1421 consecutive patients referred for physician performed VUD. After exclusion criteria, 170 patients were included. Ethics approval was obtained, followed by data collection, and analysis of demographics, symptoms, cystoscopy results, imaging, and VUD parameters. Statistical analyses were performed with IBM SPSS Statistics Version 28. Statistical significance was defined by an alpha level of P ≤0.05. Results:: Overall, 117/170 (69%) had identifiable causes of rUTI identified on VUD. There was a statistically significant difference (p<0.001) in identifying a cause in those with voiding symptoms (93/114 = 82%) compared to those without (24/56 = 43%). Gender was not predictive of an identifiable cause on VUD (p=0.47). Neither was a neurogenic history (p=0.11), diabetes (p=0.97), or age (p=0.89). Additional imaging was not diagnostic for rUTI cause. No malignancy was identified on imaging or cystoscopy. Conclusion:: In patients with rUTI, VUD may be an important investigative step to find a possible underlying cause, but it is a scarce resource. As VUD has a higher detection rate in patients with voiding symptoms, by first screening for these patients on history, VUD can be used judiciously. Cystoscopy and additional imaging were not as helpful in identifying a target treatment plan for rUTI, when a VUD had already been done.http://www.sciencedirect.com/science/article/pii/S2772974524000279CystoscopyLower urinary tract dysfunctionRecurrent urinary tract infectionsVideourodynamics
spellingShingle G. Chan
F. Davidovic
J. Gani
Role of videourodynamics, imaging, and cystoscopy in patients with recurrent urinary tract infections: Should we throw in the kitchen sink?
Continence Reports
Cystoscopy
Lower urinary tract dysfunction
Recurrent urinary tract infections
Videourodynamics
title Role of videourodynamics, imaging, and cystoscopy in patients with recurrent urinary tract infections: Should we throw in the kitchen sink?
title_full Role of videourodynamics, imaging, and cystoscopy in patients with recurrent urinary tract infections: Should we throw in the kitchen sink?
title_fullStr Role of videourodynamics, imaging, and cystoscopy in patients with recurrent urinary tract infections: Should we throw in the kitchen sink?
title_full_unstemmed Role of videourodynamics, imaging, and cystoscopy in patients with recurrent urinary tract infections: Should we throw in the kitchen sink?
title_short Role of videourodynamics, imaging, and cystoscopy in patients with recurrent urinary tract infections: Should we throw in the kitchen sink?
title_sort role of videourodynamics imaging and cystoscopy in patients with recurrent urinary tract infections should we throw in the kitchen sink
topic Cystoscopy
Lower urinary tract dysfunction
Recurrent urinary tract infections
Videourodynamics
url http://www.sciencedirect.com/science/article/pii/S2772974524000279
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