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基于人群的女性复发性尿路感染管理和预防技术。

Recurrent urinary tract infection management and prevention techniques among a population-based cohort of women.

机构信息

Department of Urology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

出版信息

Neurourol Urodyn. 2023 Nov;42(8):1676-1685. doi: 10.1002/nau.25281. Epub 2023 Sep 5.

Abstract

INTRODUCTION

Recurrent urinary tract infection (rUTI), defined as three or more UTIs in 12 months, has psychological, physical, and financial burden. Many women with rUTI are not satisfied with care and report only starting preventative measures after several infections. The goal of this study is to elucidate current UTI management trends and the implementation of UTI prevention strategies.

METHODS

A web-based study was sent to a national sample of adult women enrolled in ResearchMatch.org. Women were recruited to participate if they had a self-reported UTI in the past 12 months.

RESULTS

Of the 755 subjects, nearly 30% reported rUTI. Among women with rUTI, more than 50% reported being peri- or postmenopausal, and two-thirds reported vaginal symptoms. 15.8% of women with rUTI reported dissatisfaction with care versus 7.9% of women without rUTI. Most women see their primary care physician for UTI management and only 26% of women with rUTI follow with a urologist. More than 65% of women increase their fluid intake, wipe from front to back, and urinate after sexual activity to prevent UTIs. Significantly more women with rUTI use transvaginal estrogen, cranberry extract, and low-dose prophylactic antibiotics. These interventions appear to be driven by urologists.

CONCLUSION

Most women who have had a UTI in the last 12 months implement lifestyle changes to prevent future infections. Most women see their PCP for UTI management and women with rUTI are twice as likely to report dissatisfaction with care. Despite urologists optimizing medical rUTI prevention, they appear to be underutilized.

摘要

简介

复发性尿路感染(rUTI)定义为 12 个月内发生 3 次或以上尿路感染,其给患者带来心理、身体和经济负担。许多患有 rUTI 的女性对护理不满意,并且仅在多次感染后才开始采取预防措施。本研究旨在阐明当前尿路感染管理趋势和尿路感染预防策略的实施情况。

方法

本研究采用基于网络的方法,向 ResearchMatch.org 注册的成年女性全国样本发送问卷。如果女性在过去 12 个月内有尿路感染史,则招募其参与研究。

结果

在 755 名受试者中,近 30%的女性报告有 rUTI。在 rUTI 女性中,超过 50%的女性处于围绝经期或绝经后,三分之二的女性报告有阴道症状。15.8%的 rUTI 女性对护理不满意,而无 rUTI 的女性为 7.9%。大多数女性看其初级保健医生治疗尿路感染,只有 26%的 rUTI 女性会看泌尿科医生。超过 65%的女性增加液体摄入、从前向后擦拭和在性生活后排尿以预防尿路感染。rUTI 女性显著更多地使用阴道雌激素、蔓越莓提取物和低剂量预防性抗生素。这些干预措施似乎是由泌尿科医生推动的。

结论

大多数在过去 12 个月内发生尿路感染的女性会采取生活方式改变来预防未来感染。大多数女性看其初级保健医生治疗尿路感染,rUTI 女性对护理不满意的可能性是无 rUTI 女性的两倍。尽管泌尿科医生优化了 rUTI 的医学预防,但这些医生的利用率似乎较低。

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