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Novel treatment and prophylaxis of uncomplicated urinary tract infections 2

Part 2 of 2
Published on November 30, 2023   18 min

A selection of talks on Gastroenterology & Nephrology

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0:04
Now, in the recurrent UTI, what should we do to reduce recurrences in patients with recurrent UTI? Here you see again the definition and 10% to 20% will have recurrent UTIs. This is very bad for the patients. The treatment of the acute episode is not enough. We need something for prophylaxis.
0:30
First, we have to ask about risk factors. There are urogenital risk factors: incontinence, obstruction, sphincter detrusor dyssynergia, surgery. Of course, these we have either to improve or to consider. There are general risk factors like the history of the UTI. What does it mean? The mother has history, the daughter has recurrent UTIs. This is genetic. And diabetes mellitus, that is an immune situation, and oestrogen deficiency in post-menopausal women. But there are also behavioral risk factors: sexual intercourse, diaphragm use, spermicides and antibiotic usage, as I have shown you.
1:12
Therefore, the prevention should first go to the risk factors. For behavioral risk factors, for example, patients who don't take enough fluid or delay urination or post-coital urination delay, or wiping from back to front after defaecation. We have to ask whether this is very important or not. There are not many studies showing this. In older women we have urinary incontinence and we have the so-called non-secretor status. This is of course genetic or, if the patient has cystocele or post-void residual urine. Then, I mentioned already, sexual intercourse frequency and using different spermicides or genetic factors affecting the immune system.
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Novel treatment and prophylaxis of uncomplicated urinary tract infections 2

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