scholarly journals Hibiscus extract, vegetable proteases and Commiphora myrrha are useful to prevent symptomatic UTI episode in patients affected by recurrent uncomplicated urinary tract infections

2018 ◽  
Vol 90 (3) ◽  
pp. 203-207 ◽  
Author(s):  
Tommaso Cai ◽  
Daniele Tiscione ◽  
Andrea Cocci ◽  
Marco Puglisi ◽  
Gianmartin Cito ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
Asymptomatic Bacteriuria ◽  
Median Number ◽  
Treatment Schedule ◽  
Tract Infections

Objective: To evaluate the efficacy of a combination of Hibiscus extract, vegetable proteases and Commiphora myrrha extract in the prophylaxis of symptomatic episode in women affected by recurrent urinary tract infections (rUTIs). Materials and methods: In this phase II clinical trial, all patients with history and diagnosis of rUTI were enrolled. All patients underwent the following treatment schedule: 1 tablet in the morning and 1 tablet in the evening for 7 days and, then, 1 tablet in the evening for 10 days (1 cycle every each month, for 6 months) of a combination of Hibiscus extract, vegetable proteases and Commiphora myrrha extract. At the baseline, all patients underwent urologic visit with quality of life (QoL) questionnaires and mid-stream urine culture. After 3 and 6 months, all patients underwent urologic visit, urine culture and QoL questionnaires evaluation. Results: Fifty-five women were enrolled (mean age 49.3; range: 28-61). At the enrollment time, the most common pathogen was Escherichia coli (63.7%). The median number of UTI per 6 months was 5 (IQR: 4-9). At the end of the second follow-up evaluation, 25 women did not reported any symptomatic episode of UTI (49%), 18 reported less than 2 episodes (35.3%), while 8 reported more than 2 episodes (15.7%). However, at the first and second follow-up evaluation the clinical statistically significant improvement (QoL) was reported by 38/51 (74.5%) (p < 0.001 from baseline) and 43/51 (84.3%) (p < 0.001 from baseline) women, respectively. The median number of UTI decreased to 2 (IQR: 0-3). At the end of the follow-up period, 30/51 had sterile urine (58.8%), while 21/51 (41.2%) reported a transition from symptomatic UTI to asymptomatic bacteriuria. Conclusions: In conclusion, this treatment, in motivated patients, is able to prevent symptomatic UTI symptomatic episode and improve patient’s QoL.

scholarly journals Intravesical treatment with highly-concentrated hyaluronic acid and chondroitin sulphate in patients with recurrent urinary tract infections: Results from a multicentre survey

2014 ◽  
Vol 8 (9-10) ◽  
pp. 721 ◽  
Author(s):  
Antonio Cicione ◽  
Francesco Cantiello ◽  
Giuseppe Ucciero ◽  
Andrea Salonia ◽  
Marco Torella ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hyaluronic Acid ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Chondroitin Sulphate ◽  
Recurrent Utis ◽  
Recurrent Urinary Tract Infections ◽  
Tract Infections

Introduction: We assess the effectiveness of intravesical instillation of hyaluronic acid (HA) and chondroitin sulphate (CS) as a non-antibiotic treatment option for prophylaxis of recurrent urinary tract infections (UTIs) in female patients.Methods: This was a retrospective cohort study involving 7 European institutions. We included patients with recurrent UTIs who received intravesical instillations of Ialuril (IBSA International) (50 mL HA 1.6% and CS 2% solution) between January 2010 and March 2012. Medication schedule, length of follow-up, recurrence infection time, number of UTIs/patients/year, patient quality of life, subjective symptoms score, and treatment-emergent side effects were recorded and analyzed.Results: In total, 157 women (mean age: 54.2 ± 4.1 years) were included in the analysis. All patients had at least 12 months follow-up. After 4 weekly and 5 monthly HA-CS bladder instillations, UTI episodes decreased from 4.13 ± 1.14 to 0.44 ± 0.50 (p = 0.01) at 12 months, while recurrent UTI time prolonged from 94.8 ± 25.1 days to 178.4 ± 37.3 days (p = 0.01) at 12 months. An improvement in symptoms and quality of life was achieved. A medium-depth pain after medication instillation was the most reported side effect. Regression model analysis showed significant risk factors in developing new UTI episodes: being more than 50 years old and having more than 4 UTI episodes per year (OR 3.41; CI 95%; 1.51-7.71, p = 0.003 and OR 3.31; CI 95% 1.51-7.22; p = 0.003, respectively). Retrospective design and lack of a control group represent two main limitations of the study.Conclusions: Restoring glycosaminoglycans bladder layer therapy is a promising non-antibiotic therapy to prevent recurrent UTIs.

W069 RECURRENT LOWER URINARY TRACT INFECTIONS HAVE A DETRIMENTAL EFFECT ON PATIENT QUALITY-OF-LIFE

2012 ◽  
Vol 119 ◽  
pp. S727-S727
Author(s):  
J. Renard ◽  
M.T. Da Quinta e Costa de Mascarenhas Sa ◽  
G.J. Wirth ◽  
M. Zahran ◽  
E. Quimper ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Lower Urinary Tract ◽  
Detrimental Effect ◽  
Tract Infections ◽  
Lower Urinary

Vesicular Cystitis: A Chronic Cystitis Variant Often Unresponsive to Antibiotics and Electrofulguration

2020 ◽  
pp. 1-6
Author(s):  
Joseph J. Crivelli ◽  
Philippe E. Zimmern
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
Anterior Wall ◽  
Chronic Cystitis ◽  
Positive Urine Culture ◽  
Institutional Review ◽  
Tract Infections ◽  
Cystitis Cystica

<b><i>Objective:</i></b> The aim of the study was to report on the presentation and outcomes of vesicular cystitis (VC), a chronic cystitis exhibiting translucent bladder mucosal vesicles, among women with antibiotic-refractory recurrent urinary tract infections (RUTIs). <b><i>Methods:</i></b> An analysis of our Institutional Review Board-approved series on antibiotic-refractory RUTIs was performed, selecting for documented VC lesions on cystoscopy. All patients had RUTIs defined as ≥3 urinary tract infections/year with positive urine culture. All patients were extensively treated with antibiotics with no resolution of RUTIs and were offered electrofulguration (EF) of VC lesions under anesthesia as a last resort. All patients had a 6-month post-EF office cystoscopy documenting persistence or resolution of the lesions, and a clinical outcome assessment based on RUTI frequency. <b><i>Results:</i></b> Of 482 patients, 18 (3.7%) treated during 2011–2017 met the study criteria. VC was most commonly found over the dome/anterior wall (7/18, 38%) and as pancystitis (7/18, 38%). There was often concomitant cystitis cystica of the trigone (8/18, 44%). At post-EF cystoscopy, persistence of VC was noted in 10/18 (56%) patients; 6/18 (33%) underwent repeat EF and an additional 3/18 (17%) were retreated due to new lesions after initial resolution. Two (11%) patients required simple cystectomy and urinary diversion due to RUTIs refractory to all interventions. Within a median follow-up of 2.8 years after EF, clinical cure was observed in 5/18 (28%), improvement in 10/18 (56%), and failure in 3/18 (17%) patients. <b><i>Conclusions:</i></b> Among women with antibiotic-refractory RUTIs, VC is an infrequent and persistent form of cystitis with a predilection for non-trigonal bladder surfaces, whose management is challenging.

scholarly journals Are Urinalyses Used Inappropriately in the Diagnosis of Urinary Tract Infections?

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S350-S350 ◽  
Author(s):  
Ghada Elshimy ◽  
Vincent Mariano ◽  
Christina Mariyam Joy ◽  
Parminder Kaur ◽  
Monisha Singhal
Keyword(s):  
Urinary Tract ◽  
Antibiotic Treatment ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
White Blood Cells ◽  
Asymptomatic Bacteriuria ◽  
Further Education ◽  
Positive Urine ◽  
Tract Infections ◽  
Hospital Wards

Abstract Background One of the most readily available and cost effective tests in the diagnosis of urinary tract infections (UTI) is the urinalysis. Problems arise when antibiotic treatment is initiated in a patient who does not display typical signs and symptoms of UTI and for whom a urinalysis was obtained for other reasons. Methods This was a retrospective observational study carried out on 1000 patients with positive urine nitrite. Medical records were identified with subsequent analysis of urine culture and symptomatology. Recorded and analyzed data included: age, sex, location (emergency room (ER) or hospital ward), findings on urinalysis (pH, presence of leukocyte esterase(LE), epithelial cells, bacteria, and white blood cells (WBCs)) and antibiotic treatment. Results Of these 1000 patients with positive nitrite, we excluded 815 patients (81 had missing data, 466 met exclusion criteria and 268 had symptomatic UTI). 185 were found to not have any symptoms of a UTI. Inappropriate antibiotic treatment occurred in 108/185 patients (58.4%) and was significantly associated with greater amounts of bacteria and WBCs in the urinalyses (P = 0.008 and P = 0.029, respectively). It was also significantly more likely to occur in the ER than the hospital wards (92/147 treated in the ER vs. 16/37 treated on the hospital wards, P = 0.033). There was no significant association between antibiotic treatment and age, sex, urine pH, urine LE, and urine epithelial cell amounts (P &gt; 0.05). Urine cultures were not obtained in 69.7% of patients. A positive urine culture was significantly associated with inappropriate antibiotic treatment (P = 0.0006). The two most common presenting complaints were psychiatric complaints (21.6%) and vaginal bleeding (14.6%). Conclusion Urinalysis can be an invaluable diagnostic tool, but must be used and interpreted appropriately. There is a misperception that pyuria with bacteriuria defines UTI. However, positive results on a urinalysis alone in an asymptomatic patient is not enough to diagnose a UTI, and antibiotic treatment is only indicated in specific circumstances as outlined by IDSA guidelines for the treatment of asymptomatic bacteriuria. Further education targeting appropriate interpretation of urinalyses and IDSA guidelines is needed to decrease the unnecessary use of antibiotics. Disclosures All authors: No reported disclosures.

Letter to the Editor

PEDIATRICS ◽  
1974 ◽  
Vol 53 (2) ◽  
pp. 289-289
Author(s):  
Thomas F. Dolan ◽  
Alan Meyers
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
Family Practitioners ◽  
Letter To The Editor ◽  
Routine Basis ◽  
Tract Infections

We agree that follow-up urine culture should be obtained after the diagnosis of a urinary tract infection is made. The frequency with which such cultures are obtained is, however, debatable. Our questionnaire did not include this aspect of management. Since 59% of family practitioners and 45% of pediatricians diagnosed urinary tract infections without benefit of culture on a routine basis, it would seem likely that follow-up urine cultures are not performed with regularity. We would join with Dr. Browning in urging careful follow-up and evaluation for children with documented urinary tract infections.

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