about Urinary Tract Infections
The impact of urinary tract infections (UTIs) in women is recognized as a substantial burden on patients as well as on the health care delivery system. The annual incidence of recurrent urinary tract infections is 0.5-0.7 episodes per person per year in sexually active women. As the leading consumer of health care, women are also disproportionately affected by urinary tract infections. Recurrent urinary tract infections remain a leading cause for office visits, medical expenditures, and antibiotics prescribed annually. Efforts have been undertaken to delineate the various factors which ultimately predispose the female patient to recurrent urinary tract infections. Metro Urology has organized a standardized approach to the evaluation, management, and prevention of recurrent episodes.
It has been suggested that the total expenditure for the treatment of UTIs in American women was estimated to be greater than $2 billion and this estimate had not included coverage for outpatient prescriptions. Between 1994 and 2000, composite data had shown that spending increased about 1% annually. UTIs clearly have an overarching impact on the quality of life for women affected by this frustrating condition. Even though UTIs can be common to women of all ages, the prevalence is greater in women between the ages of 18 and 34. Understandably, a large proportion of women bear with their symptoms as some phenomenon which is relegated to females and in their search for a cause and a cure have had their concerns and their frustrations appeased by empiric antibiotic treatment while bearing the burden of cost and/or a work-up that has provided very low yield. Therefore, it is important to definitively understand the natural history of what predisposes women to developing recurrent UTIs in order to minimize recurrence, maximize control and improve quality of life.
The factors which predispose women to recurring UTIs are likely to differ based not only on age but on other characteristics within the given population. Frequency of intercourse in young women is a strong risk factor for sporadic infections and also seems to predominate in recurring UTIs, while in older populations of women the role of sexual and contraceptive practices diminish and potentially modifiable factors seem to prevail.
There are various tools at our disposal for the evaluation of patients with recurrent UTIs. A detailed history is, by all accounts, one of the most critical parts needed to formulate diagnoses and organize an approach to managing UTIs and recurrences. The duration and frequency of recurrence are questions which also help us to stratify a plan of care and also reveal concerns which might suggest pre-existing renal disease or anatomic abnormalities. Ultimately, we hope that our patients allow us to participate in caring for them as they also remain actively involved in their own care.