Cystoscopy Findings in Females with Recurrent Urinary Tract Infection

Recurrent urinary tract infection is common in adult females. This study aimed at identifying lower urinary tract abnormalities in females with recurrent urinary tract infections based on cystoscopy findings and evaluating the diagnostic yield of cystoscopy in these patients.
In this cross-sectional study, females (above 18 years) with recurrent urinary tract infection, who were referred to the urology clinic of Kerman University of Medical Sciences, Iran, in 2014 to 2016, were evaluated. After collecting demographic information, urine culture and urinary tract ultrasonography were performed for all patients; those with gross or microscopic hematuria, abnormality in imaging, neurogenic bladder, genitourinary cancer, and congenital urinary tract abnormality were excluded. Eligible patients underwent urethrocystoscopy, and the findings were recorded. Associations between clinical risk factors and abnormal findings were analyzed.
Of the 88 patients (mean age of 48 years), who underwent urethrocystoscopy, urinary tract abnormalities were reported in 36 (40.9%) patients, among whom 19 (21.5%) and 17 (19.4%) had clinically significant and non-significant abnormalities, respectively. Significant abnormalities included 14 cases of urethral stricture, one case of mesh erosion into the urethra, one case of periurethral gland abscess, two cases of bladder diverticulum, and one case of refluxing ureteral orifice.
Although the majority of urinary tract abnormalities among females with recurrent urinary tract infection could be identified via imaging modalities, yet, it seems that cystoscopy is an appropriate method for the diagnosis of urinary tract disorders in some cases, especially in patients, who are unresponsive to common treatment strategies.