Midterm Follow-up of Electrofulguration for Vesicular Cystitis in Women With Recurrent Urinary Tract Infections

Tze-Chen Chao; Alana L Christie; Feras Alhalabi; Philippe E Zimmern

doi:10.1016/j.urology.2024.10.072

Midterm Follow-up of Electrofulguration for Vesicular Cystitis in Women With Recurrent Urinary Tract Infections

Urology. 2024 Nov 19:S0090-4295(24)00972-5. doi: 10.1016/j.urology.2024.10.072. Online ahead of print.

Authors

Tze-Chen Chao¹, Alana L Christie², Feras Alhalabi³, Philippe E Zimmern⁴

Affiliations

¹ Division of Urology, Department of Surgery, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX 75390-9110. Electronic address: S99311106@gmail.com.
² Simmons Comprehensive Cancer Center Biostatistics, University of Texas Southwestern Medical Center, Dallas, TX 75390-8852. Electronic address: Alana.Christie@UTSouthwestern.edu.
³ Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX 75390-9110. Electronic address: Feras.Alhalabi@UTSouthwestern.edu.
⁴ Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX 75390-9110. Electronic address: Philippe.Zimmern@UTSouthwestern.edu.

PMID: 39566589
DOI: 10.1016/j.urology.2024.10.072

Abstract

Objective: To report the midterm outcomes of women with symptomatic recurrent urinary tract infections (RUTIs) with findings of vesicular cystitis (VC) on cystoscopy treated with bladder electrofulguration (EF) and to identify factors affecting successful treatment outcome.

Methods: Following Institutional Review Board approval, a prospectively collected long-term database of women with RUTI and VC treated with EF was retrospectively reviewed. Patients were divided into two groups based on the associated presence of urinary obstruction ("obstructed group") or not. Follow-up included an office cystoscopy 6 months after EF. The primary outcome evaluated was rate of urinary tract infections (UTIs) recurrences over time.

Results: From 2010 to 2023, 50 women met all study criteria, with 94% being postmenopausal. Overall, the 3-year UTI-free survival from repeat fulguration was 71.4% (95% CI, 54.4-83.0). Kaplan-Meier analysis showed that patients with obstruction had a higher 3-year survival of no UTI recurrence (40.3%; 95% CI: 18.2, 61.7) than patients without obstruction (20.8%; 95% CI: 6.2, 41.4], P = .0085).

Conclusion: Over two-thirds of women with VC and symptomatic UTI did not need a second EF or daily antibiotic prophylaxis after the initial EF. Those with VC related to bladder outlet obstruction experienced less RUTIs and a longer time to a repeated EF.