Characteristics of women attending first level gynecological outpatient services with symptoms suggesting urinary tract infection: an observational study

Background. Urinary tract infection (UTI) is a common condition in the gynecological practice. Despite its clinical relevance, few epidemiological data are available on the characteristics/ symptoms of women with UTI and the clinical approach to the condition in the gynecological practice in Italy. material and methods. This is a multicenter observational study. Eligible for the study were women with a clinical or laboratory diagnosis of UTI, consecutively identified in 15 Italian outpatients gynecological centers. If a treatment for the UTI was given, the woman was asked to come back for a follow-up visit according clinical practice 8-10 days after study entry. results. A total of 401 women entered the study. Most of the enrolled cases were >= 44 years old (218, 54.4%) and 170 women (42.4%) were in post menopause. A total of 269 (67.1%) women reported one or more UTIs during the year before the study entry. The most common reported symptom at diagnosis was dysuria followed by urgency. Haematuria was reported in 93 cases (23.2%). The diagnosis was based on clinical symptoms in 138 cases. Confirmation test (urine sample for microbiological test) was required in 263 (65.6%) women. With regard to treatments: ciprofloxacin (including Ciprofloxacin RM, the once daily formulation) was the most commonly prescribed treatment. A treatment with supplements was prescribed in 86 (21.4%) cases. In 82 (20.5%) cases no specific treatment was given. A total of 266 (83.4%) women were followed up out of 319 treated women. Clinical resolution of symptoms was reported by 219 cases (83.0%). The risk of recurrent infection increased with age, being, in comparison with women aged 29 years or less, 2.0 and 4.3 respectively in women aged 30-43 years and >=44 years (chi square trend P<0.05). Other factors found statistically significantly associated with the risk of recurrent infection were post menopausal status (OR in post menopausal vs pre menopausal women 2.7, 95% CI 1.4-5.5) and history of constipation (OR 1.9, 95% CI 1.1-3.2) or irritable bowel syndrome (OR 5.25, 95% CI 1.7-16.1). Conclusion. The present study underlines that recurrent UTI is commonly observed among women with UTI in outpatients gynecological services. Dysuria is the most common symptoms for gynecological consultation among women with clinical suspect of UTI and urine sample is required in approximately 65% of women before treatment.