PD8-02 UPPER TRACT IMAGING ABNORMALITIES RELATED TO RECURRENT URINARY TRACT INFECTIONS RARELY FOUND IN WOMEN

Abstract

You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Kidney & Bladder I1 Apr 2015PD8-02 UPPER TRACT IMAGING ABNORMALITIES RELATED TO RECURRENT URINARY TRACT INFECTIONS RARELY FOUND IN WOMEN Lauren Rego, Alana Christie, and Philippe Zimmern Lauren RegoLauren Rego More articles by this author , Alana ChristieAlana Christie More articles by this author , and Philippe ZimmernPhilippe Zimmern More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.917AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To investigate the rate of upper tract imaging abnormalities as possible source for UTI recurrence in women with documented RUTIs. METHODS Following IRB approval, a prospective database of non-neurogenic women with documented RUTIs (≥ 3 UTI/year) was reviewed for relevant demographic and clinical data (Table 1), as well as radiology-interpreted upper tract imaging study (renal ultrasound (US), CT scan, IVP) findings. Patients were excluded for irretrievable image (3), no imaging study performed (13), an obvious source for RUTI (intermittent catheterization, indwelling catheter, > stage 2 anterior prolapse)(8), or history of pyelonephritis (1). Any upper tract imaging anomaly was recorded. RESULTS From 2006 to 2014, 170 of 280 women with RUTIs were studied, including US alone (N=76), CT alone (N=47), US and CT (N=38), and IVP with US or CT (N=9). Out of total imaging findings (N=84 in 76 women), 81/84 (96.4%) were noncontributory: duplicated systems (10), non-obstructing renal stone (16), renal cyst (46), renal tumor (1), questionable small renal lesion (8). In 3/76 women (3.6%), mild unilateral hydronephrosis appeared related to RUTI; but no clinical parameters (BMI, gravida, parity, immunosuppression, history of urethral dilation or kidney stones, degree of cystocele, infecting strain, post-void residual) were correlated with these upper tract findings. Six of 15 (40%) patients with kidney stone history had stones on imaging (ranging from 1–3 mm) versus 10/155 (6.5%) of patients that did not have such history had stones on imaging (p < 0.0001). CONCLUSIONS In this cohort of predominantly Caucasian post-menopausal women, upper tract imaging yielded a low percentage of significant findings associated with RUTIs, thus questioning the routine practice of upper tract studies in this population. Table 1. Patient demographics (N = 170) N/Total (%) Age (avg. ± std. dev.) 62.7 ± 14.9 BMI (avg. ± std. dev.) 26.4 ± 6.5 Race White 160/170 (94%) Other 10/170 (6%) Diabetes 13/170 (8%) Immunosuppression 7/170 (4%) Post-Menopausal 133/163 (82%) Sexually Active 57/107 (53%) Voiding Dysfunction 72/165 (44%) History of Urethral Dilation 32/169 (19%) History of Kidney Stones 15/169 (9%) Cystocele Stage 0 99/155 (64%) Stage 1 45/155 (29%) Stage 2 11/155 (7%) Current Chemotherapy Yes 2/170 (1%) © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e190 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Lauren Rego More articles by this author Alana Christie More articles by this author Philippe Zimmern More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...