Electrofulguration effective against recurrent UTI in menopausal women

Treatment with electrofulguration for antibiotic-refractory recurrent urinary tract infections (UTI) demonstrates durable clinical cure and improvement over 5 years in menopausal women, reducing the need for long-term antibiotics, a study has shown.

Ninety-six women (median age 64 years) from 2006 to 2012 were included in this study, with a median follow-up of 11 years. Seventy-one participants had >10-year follow-up.

Of the women, 74 percent used daily antibiotic suppression, 5 percent used postcoital prophylaxis, 14 percent used self-start therapy, and 7 percent did not receive prophylaxis prior to electrofulguration. At the last visit after electrofulguration, 72 percent of participants were cured, 22 percent showed improvement, and 6 percent failed treatment.

In addition, use of antibiotics decreased following electrofulguration (p<0.05). Of the women, 5 percent were on continuous antibiotic therapy at last follow-up relative to 74 percent prior to the procedure (McNemar p<0.05). Of note, 19 percent had a repeat electrofulguration.

The authors, following Institutional Review Board approval, analysed non-neurogenic women ≥3 symptomatic recurrent UTI episodes per year and inflammatory lesions on cystoscopy who underwent electrofulguration, except those with alternate identifiable aetiology for recurrent UTIs or <5-year follow-up. They reported preoperative characteristics, antibiotic regimens, and annual UTIs.

The primary endpoints included clinical cure (0‒1 UTI per year), improvement (>1 and <3 per year), or failure (≥3 per year) at last follow-up. The secondary endpoint was need for antibiotics or repeat electrofulguration. The authors also performed a subanalysis on women with >10-year follow-up.