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Pelvic floor dysfunction is not a risk factor for febrile urinary tract infection in adults
Author(s) -
Van Nieuwkoop Cees,
Voorhamvan der Zalm Petra J.,
Van Laar AnneMarike,
Elzevier Henk W.,
Blom Jeanet W.,
Dekkers Olaf M.,
Pelger Rob C.M.,
Van Aartrijkvan Dalen A. Mieke,
Van Tol Marjanne C.,
Van Dissel Jaap T.
Publication year - 2010
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2009.09056.x
Subject(s) - urinary system , medicine , risk factor , urology
Study Type – Therapy (case control)
Level of Evidence 3b 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. PATIENTS AND 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 ≥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.