Recurrent urinary tract infections in postmenopausal women.
To evaluate factors associated with recurrent urinary tract infection (UTI) in postmenopausal women, we conducted a case-control study comparing 149 postmenopausal women referred to an infectious diseases outpatient clinic who had a history of recurrent UTI (case patients) with 53 age-matched women without a history of UTI (control patients). Each woman completed a questionnaire providing demographic data, history and clinical characteristics of prior infections, and information regarding risk factors for UTI. In addition, each patient underwent a gynecologic evaluation, renal ultrasound and urine flow studies, and blood group and secretor status testing. Three urologic factors-namely, incontinence (41% of case patients vs. 9.0% of control patients; P<.001), presence of a cystocele (19% vs. 0%; P<.001), and postvoiding residual urine (28% vs. 2.0%; P=.00008)-were all strongly associated with recurrent UTI. Multivariate analysis showed that urinary incontinence (odds ratio [OR], 5.79; 95% confidence interval [CI], 2.05-16.42; P=.0009), a history of UTI before menopause (OR, 4.85; 95% CI, 1.7-13.84; P=. 003), and nonsecretor status (OR, 2.9; 95% CI, 1.28-6.25; P=.005) were most strongly associated with recurrent UTI in postmenopausal women. Prospective studies are needed to confirm these observations and to develop approaches for prevention.
Raz
R
R
Infectious Diseases Unit, Haemek Medical Center, and Technion Faculty of Medicine, Haifa, Israel.
Gennesin
Y
Y
Wasser
J
J
Stoler
Z
Z
Rosenfeld
S
S
Rottensterich
E
E
Stamm
W E
WE
D000368:Aged; D001789:Blood Group Antigens; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D017698:Postmenopause; D012008:Recurrence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000209:etiology*
D001789:Blood Group Antigens