Long‐term efficacy of complete trigonal electrofulguration for women with recurrent urinary tract infections

Introduction and Objective Recurrent urinary tract infections (R‐UTIs) have a negative impact on quality of life and contribute to antimicrobial resistance. Long‐term antibiotic therapy is the main treatment alternative but, in some cases, this approach may not be accepted by the patient, is ineffec...

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Published in:Neurourology and urodynamics 2023-01, Vol.42 (1), p.188-193
Main Authors: Ribeiro‐Filho, Leopoldo, Suartz, Caio V., Braz, Natalia D. S. F., Siqueira, Matheus, Hirasaki, Felipe, Mitre, Anuar I., Gomes, Cristiano M., Nahas, William C.
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents - therapeutic use
antibiotic
Antibiotics
Antimicrobial resistance
electrofulguration
Female
Humans
infection
Middle Aged
profilaxy
Prospective Studies
Quality of Life
recurrent urinary tract infection
trigone fulgurarion
Urinalysis
Urinary tract
Urinary tract diseases
urinary tract infection
Urinary tract infections
Urinary Tract Infections - etiology
Urogenital system
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Summary:Introduction and Objective Recurrent urinary tract infections (R‐UTIs) have a negative impact on quality of life and contribute to antimicrobial resistance. Long‐term antibiotic therapy is the main treatment alternative but, in some cases, this approach may not be accepted by the patient, is ineffective or poorly tolerated. In selected women, electrofulguration (EF) of trigonal lesions has been shown to reduce urinary tract infection (UTI) episodes. Methods Between August 2006 and December 2017, 73 women with R‐UTI had their data collected prospectively and analyzed. We evaluated the rate of UTIs during the initial 2 years of follow‐up after fulguration based on symptoms and a positive urine culture. All patients failed with multiple antibiotic courses and were offered endoscopic electrofulguration of the entire trigonal and bladder neck mucosa with a rollerball probe. We present our long‐term results using a strategy of complete fulguration of the trigone in women with R‐UTIs. Results The median age was 64 years (range: 17–76 years) and the median follow‐up time after EF was 4.2 years (range: 2.5–14 years). Overall, 70 patients (96%) remained free of UTI episodes during the first year of follow‐up, at 2 years of follow‐up, 57, 53% remained infection‐free. Currently, UTIs are typically sparse, mild, and caused by multisensitive bacteria. Conclusions Complete trigonal and bladder neck mucosal fulguration promoted a significant reduction of UTI episodes during the first 2 years of follow‐up. Prospective controlled studies are needed to determine the role of EF in women with R‐UTI.
ISSN:0733-2467
1520-6777
DOI:10.1002/nau.25066