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 New Study: Recalcitrant chronic bladder pain and recurrent cystitis but negative urinalysis: What should we do?

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Andi2016

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Join date : 2016-01-07

PostSubject: New Study: Recalcitrant chronic bladder pain and recurrent cystitis but negative urinalysis: What should we do?   Sun Mar 25, 2018 3:04 pm

Here's a new paper published: 'Recalcitrant chronic bladder pain and recurrent cystitis but negative urinalysis: What should we do?'
You can read the full paper here: https://rd.springer.com/article/10.1007/s00192-018-3569-7

PURPOSE
Lower urinary tract symptoms (LUTS) may be associated with chronic urinary tract infection (UTI) undetected by routine diagnostic tests. Antimicrobial therapy might confer benefit for these patients.

CONCLUSION
This large case series demonstrates that patients with chronic LUTS and pyuria experience symptom regression [ie improvement] and a reduction in urinary tract inflammation [ie pyuria] associated with antimicrobial therapy. Disease regression was achieved with a low frequency of Adverse Effects.

TO SUMMARISE
• 624 women were treated for chronic Lower Urinary Tract Symptoms (LUTS) / pyuria, including patients previously diagnosed with IC/PBS, recurrent UTI (rUTI) and voiding symptoms.

• The average patient had suffered symptoms for 6.5 years

• In LUTS clinic samples, 28% showed leucocytes and 7% showed nitrites [signs of infection] by dipsticks, whilst 72% showed microscopic pyuria.

• Mid-Stream Urine (MSU) tests showed an even greater contrast, with only 16% showing infection under standard criteria [> 105 cfu ml-1], whilst 79% showed microscopic pyuria.

• After treatment (an average period of just over a year and five visits), 225 patients (36%) completed treatment and were discharged. Overall, 84% of women rated their condition as: much better (20%) or very much better (64%).

• In 273,000 treatment days, mild to moderate adverse events [side-effects] totalled 475 or 0.0017%, which resulted in a change of antibiotics in all cases; there was one serious adverse event.

• A total of 73% of patients experienced damped oscillation of decreasing amplitude during treatment.

• No increase in the proportion of resistant bacterial isolates was observed from 362 positive MSU cultures tested.
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