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Nieuwkoop, C. van; Voorham-van der Zalm, P.J.; Laar, A.M. van; Elzevier, H.W.; Blom, J.W.; Dekkers, O.M.; ... ; Dissel, J.T. van (2010)

Pelvic floor dysfunction is not a risk factor for febrile urinary tract infection in adults

Article / Letter to editor
OBJECTIVE To determine whether pelvic floor dysfunction (PFD) might be a risk factor for or consequence of febrile urinary tract infection (UTI), as UTI in adults is a common infection in which an underlying urological abnormality is often considered, and as in children, PFD is also thought to have a pathophysiological role in adults with UTI. PATIENTS AND METHODS A multicentre case-control study was conducted at 26 primary-care centres and at six Emergency Departments of regional hospitals. Cases were consecutive patients aged >= 18 years, who presented with febrile UTI. Controls were randomly selected subjects who visited their general practitioner for reasons other than UTI or fever. A validated pelvic floor questionnaire (the Pelvic Floor Inventories Leiden, PelFIs) was used to assess pelvic floor function. RESULTS Between October 2006 and December 2007, 153 cases were included; of these, the completed questionnaires of 102 (response rate 67%) were compared to those of 100 of...Show moreOBJECTIVE To determine whether pelvic floor dysfunction (PFD) might be a risk factor for or consequence of febrile urinary tract infection (UTI), as UTI in adults is a common infection in which an underlying urological abnormality is often considered, and as in children, PFD is also thought to have a pathophysiological role in adults with UTI. PATIENTS AND METHODS A multicentre case-control study was conducted at 26 primary-care centres and at six Emergency Departments of regional hospitals. Cases were consecutive patients aged >= 18 years, who presented with febrile UTI. Controls were randomly selected subjects who visited their general practitioner for reasons other than UTI or fever. A validated pelvic floor questionnaire (the Pelvic Floor Inventories Leiden, PelFIs) was used to assess pelvic floor function. RESULTS Between October 2006 and December 2007, 153 cases were included; of these, the completed questionnaires of 102 (response rate 67%) were compared to those of 100 of 110 (response rate 91%) controls. The median age of cases and controls was 65 and 58 years, respectively; 40% of cases and controls were men. The percentage of PelFIs outcomes consistent with PFD were comparable between cases and controls, at 21% vs 23%, respectively (odds ratio 0.9, 95% confidence interval, CI, 0.4-1.78). In the multivariate analysis, comorbidity (odds ratio 4.9, 95% CI 2.2-11.1) and a history of UTI (odds ratio 2.5, 95% CI 1.0-6.1) were independent significant risk factors for febrile UTI, whereas PFD was not (odds ratio 1.0, 0.5-2.2). Within the group of cases, PFD was not associated with bacteriuria during assessment of PelFIs (odds ratio 1.1, 95% CI 0.4-3.5) and inversely related to a history of UTI within the previous year (odds ratio 0.2, 0.1-0.9). CONCLUSIONS PFD is common among adults but it does not seem to be a risk factor for febrile UTI.Show less
pelvic floor dysfunction acute pyelonephritis adults urinary tract infection acute pyelonephritis escherichia-coli vesicoureteral reflux postmenopausal women elimination syndrome men diagnosis management virulence
All authors
Nieuwkoop, C. van; Voorham-van der Zalm, P.J.; Laar, A.M. van; Elzevier, H.W.; Blom, J.W.; Dekkers, O.M.; Pelger, R.C.M.; Aartrijk-van Dalen, A.M. van; Tol, M.C. van; Dissel, J.T. van
Date
2010-06-30
Journal
BJU International
Volume
105
Issue
12
Pages
1689 - 1695