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神经原性下尿路功能障碍患者行视频尿动力学检查后报告的尿路感染体征和症状:一项单中心观察性研究。

Patient-reported signs and symptoms of urinary tract infections after video-urodynamic studies in individuals with neurogenic lower urinary tract dysfunction-A single-center observational study.

机构信息

Neuro-Urology, Swiss Paraplegic Research, Nottwil, Switzerland.

Neuro-Urology, Swiss Paraplegic Centre, Nottwil, Switzerland.

出版信息

Neurourol Urodyn. 2024 Sep;43(7):1609-1616. doi: 10.1002/nau.25516. Epub 2024 May 27.

DOI:10.1002/nau.25516
PMID:38801121
Abstract

BACKGROUND

Video-urodynamic studies (VUDS) are the recommended standard of diagnostic care to objectively assess neurogenic lower urinary tract dysfunction (NLUTD) in individuals with spinal cord injury/disease (SCI/D). This examination requires the insertion of a catheter into the bladder, which increases the risk of a urinary tract infection (UTI). Data on symptomatic UTIs after VUDS are limited.

METHODS

A single-center, observational study was conducted to evaluate the incidence of patient-reported UTI signs and symptoms 7 days after VUDS. No peri-interventional antibiotics were administered. The effect of sex, age, SCI/D duration, bladder evacuation method, bacteriuria, UTI prophylaxis, UTI history, or unfavorable VUDS results on the occurrence of patient-reported UTI signs or symptoms after VUDS was examined using binary logistic regression analysis.

RESULTS

A total of 140 individuals with a mean age of 59.1 ± 14.0 years and a median SCI/D duration of 15.0 years (6/29 years) were evaluated. Seven days (mean 7 ± 1 days) after VUDS, 42 (30%) individuals reported at least one UTI sign or symptom. In the majority, signs and symptoms resolved without the need for antibiotic treatment, which was required in seven participants (5%). Male sex significantly (p = 0.04) increased the odds (odds ratio 3.74) of experiencing UTI signs and symptoms after VUDS.

CONCLUSIONS

In individuals with NLUTD, 30% experienced UTI signs and symptoms 1 week after VUDS. However, these signs and symptoms were transient and only 5% required antibiotic treatment. Thus, antibiotic prophylaxis does not seem necessary in all individuals with SCI/D undergoing VUDS.

摘要

背景

视频尿动力学研究(VUDS)是评估脊髓损伤/疾病(SCI/D)患者神经源性下尿路功能障碍(NLUTD)的推荐标准诊断方法。该检查需要将导管插入膀胱,这会增加尿路感染(UTI)的风险。关于 VUDS 后症状性 UTI 的数据有限。

方法

进行了一项单中心观察性研究,以评估 VUDS 后 7 天患者报告的 UTI 体征和症状的发生率。没有给予围手术期抗生素。使用二元逻辑回归分析检查性别、年龄、SCI/D 持续时间、膀胱排空方法、菌尿、UTI 预防、UTI 病史或不利的 VUDS 结果对 VUDS 后患者报告的 UTI 体征或症状发生的影响。

结果

共评估了 140 名平均年龄为 59.1±14.0 岁、SCI/D 持续时间中位数为 15.0 年(6/29 年)的个体。VUDS 后 7 天(平均 7±1 天),42(30%)名个体报告至少有一种 UTI 体征或症状。在大多数情况下,无需抗生素治疗即可缓解这些体征和症状,有 7 名参与者(5%)需要。男性性别显著(p=0.04)增加了 VUDS 后发生 UTI 体征和症状的几率(优势比 3.74)。

结论

在 NLUTD 患者中,30%的人在 VUDS 后 1 周出现 UTI 体征和症状。然而,这些体征和症状是短暂的,只有 5%需要抗生素治疗。因此,并非所有接受 VUDS 的 SCI/D 患者都需要预防性使用抗生素。

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