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


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 > or =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.
van Nieuwkoop
Cees
C
Department of Infectious Diseases, Leiden University Medical Center, Leiden, the Netherlands. c.van_nieuwkoop@lumc.nl
Voorham-van der Zalm
Petra J
PJ
van Laar
Anne-Marike
AM
Elzevier
Henk W
HW
Blom
Jeanet W
JW
Dekkers
Olaf M
OM
Pelger
Rob C M
RC
van Aartrijk-van Dalen
A Mieke
AM
van Tol
Marjanne C
MC
van Dissel
Jaap T
JT
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D005334:Fever / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017773:Pelvic Floor / Q000503:physiopathology*; D011704:Pyelonephritis / Q000209:etiology*; D014552:Urinary Tract Infections / Q000209:etiology*