#22928

Office Flexible Cystoscopy and Voiding Cystourethrogram in the Evaluation of Women with Recurrent Urinary Tract Infections and Their Influence on Treatment

Ordonez J1, Christie A2, Zimmern P1

1. Department of Urology, U.T. Southwestern Medical Center, 2. Simmons Compr Cancer Center, U.T. Southwestern Medical Center

KEYWORDS: Female, Infection, Urinary Tract, New Instrumentation

Current diagnosis of women with recurrent urinary tract infections (RUTIs) is based on prior documented urine cultures (at least 3 in the past year). The most recent American Urological Association (AUA) 2019 guidelines suggests that evaluation include a patient history that confirms prior UTI diagnoses, urinalysis, urine culture sensitivity, and a pelvic exam. Upper tract and lower tract imaging, cystoscopy, and urodynamic studies are reserved for circumstances in which complicating factors are suspected[1]. However, various urological abnormalities (reflux, urethral diverticulum, bladder prolapse, etc.) have been attributed to bacterial persistence leading to RUTIs in past literature and have been detected or confirmed by voiding cystourethrogram (VCUG). In addition, inflammatory lesions (trigonitis, chronic cystitis cystica, and vesicular cystitis) have been noted on cystoscopy during RUTI evaluation and have also been linked to RUTIs[2].

Our group has used office flexible cystoscopy and voiding cystourethrogram (VCUG) in the evaluation of women with RUTIs. Previous studies evaluating the yield of cystoscopy in women are few, with many reporting inflammatory lesions as non-specific, while VCUG studies have been limited to pediatric populations. Therefore, we aim to report the yield of office flexible cystoscopy and VCUG in the evaluation of women with RUTIs and their influence on treatment plans.