부산대학교 도서관

Purpose: Recurrent urinary tract infections (RUTIs) are common among adult women. We evaluated the long-term outcomes and risk factors for RUTIs in women who underwent a cystoscopy with fulguration (CF) procedure for antibiotic-recalcitrant RUTI. Method: Following Institutional Review Board approval, a prospectively maintained database of 95 women who underwent CF for RUTIs was reviewed. We defined the starting point of the follow-up period at six months after CF. RUTIs was defined as two UTIs within six months or three in the same one-year period. The Kaplan-Meier method estimated the probability of not experiencing RUTIs post-CF. Cox proportional-hazards models identified the risk factors for post-CF RUTI and their hazard rates in this cohort. Result: The follow-up period spanned 16 years (2004--2020). Mean time to resumption of post- CF RUTIs was 868 days. There was a 0.252 probability of not experiencing RUTIs by the end of the study. Four statistically significant risk factors were identified: smoking, coital prophylaxis, fluoroquinolone resistance, and extended spectrum beta lactamase-producing organisms, with hazard ratios (HRs) 3.43, 9.20, 4.54, and 5.42, respectively. Assuming other significant factors remained constant, compared to patients experiencing a UTI during the first year of follow-up, patients who remained UTI-free over that period were less likely to experience RUTIs (HR = 0.21, p < 0.001). Conclusion: Following CF, approximately a quarter of patients did not experience RUTIs in the long term. Patients who remained UTI-free in the first year of follow-up were approximately five times less likely to experience RUTIs in the future. These risk estimates will aid in counseling patients. [ABSTRACT FROM AUTHOR]