Pat, J.J. (2018) Evaluation of the diagnostic procedures in women with recurrent uncomplicated urinary tract infections: a retrospective study. thesis, Medicine.
Full text available on request.Abstract
Introduction Urinary tract infections (UTI) are one of the most common bacterial infections. Some patients have recurrent UTIs. The NHG guideline on UTI recommends referral if the UTI recurs despite given prophylaxis. At Isala, an average of 5 new patients who have been referred because of UTI are seen on weekly basis. These patients receive standard care defined as normal at Isala. The local urologists suspect limited yield of the applied diagnostics. The aim of this study is to review the diagnostic procedures and to study possible predictors for performing additional diagnostics. Material and methods This is a retrospective analysis, based on routine clinical data from patients referred for recurrent UTIs between 01-01-2016 and 31-12-2017 as registered in the medical files at Isala. The data was analyzed to identify possible predictors for receiving additional diagnostics using logistic regression. We have then quantified the yield of the standard and additional diagnostics. Results In total 204 patients were included in the analysis. Micturition diary data was available in 166 cases of which 32 patients (19%) had an insufficient intake. Uroflowmetry was available in 188 patients and revealed 57 abnormalities. A total of 149 patients (73%) received additional diagnostics, 104 cystoscopies and 108 ultrasounds. In total they revealed 13 abnormalities and altered treatment in 6 cases. In total 52 patients received treatment deviating from the NHG guideline. When imaging was normal, cystoscopy was also normal in all cases. Age and haematuria were associated with receiving additional diagnostics (P<0,05). Conclusion In our study, the odds of receiving additional diagnostics were higher with an increase in age and the presence of haematuria. The diagnostic yield was 6 and 8% respectively for cystoscopy and ultrasound, all patients with abnormalities were over 55 years of age. Younger women and patients with a normal ultrasound could be excluded from cystoscopy in the future, further research is required.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Supervisors: and Blanker, M.H. MD PhD and and Steffens, M.G. MD PhD and Location: Isala hospital Zwolle, department of urology. Univ |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:43 |
| Last Modified: | 25 Jun 2020 10:43 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/469 |
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