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abstract

419 - ACUTE PYELONEPHRITIS IN YOUNG AND SEXUAL ACTIVE WOMEN

419

ACUTE PYELONEPHRITIS IN YOUNG ANDSEXUAL ACTIVE WOMEN

M. BALZARRO, E. RUBILOTTA, A.PORCARO, N. TRABACCHIN, M. CERRUTO, W. ARTIBANI;
Urology, AOUIVerona, Verona, Italy.

Introduction: The main riskfactors for pyelonephritis are: obstructive uropathy, diabetesmellitus, and being older. Moreover, there is a no standarddefinition of pyelonephritis in literature.
Objective: Wedid an observational prospective evaluation of all the women admittedto our Department in the last year with a certain diagnosis ofpyelonephritis. The aim of the study was to assess the correlationsbetween the renal infection and post coital urinary infection inyoung women with no associated risk factors forpyelonephritis.
Methods: This is a prospectiveobservational study of all the women admitted to our Department forpyelonephritis from January 2016 to January 2017. All patients hadflank pain, fever, positive urinalysis, high blood infectionbiomarkers, and a CT scan documenting the renal infection. Exclusioncriteria were: age > 45 y.o., diabetes, the presence of urinarystones, previous surgery of urinary tract, urinary tract pathologycausing obstruction, neurogenic disorders. All women included in thecohort had to be sexually active.
Results: Of 54 patientsadmitted for pyelonephritis only 23 women (42.6%) were eligible forthe study. The mean age was 31.2 years. None patient reported ahistory of Low Urinary Tract Symptoms (LUTS). Post-coital urinaryinfections were reported in 43.4% of the patients (10/23). In thepost-coital urinary infection group 80% (8/10) reported recurrentUrinary Tract Infections (UTI), while in the non post-coital groupinfection only 23% of the women (3/13) had recurrent UTI. Clinicaldate are reported in table 1.
Conclusions: Thisobservational prospective study tried to understand the causes ofpyelonephritis in young fertile women without risk factors for renalinfection associated. In these patients post-coital urinary infectioncould be a misunderstood risk factor. Indeed, our data showed a highrate of post-coital urinary infection in young women admitted tohospital for pyelonephritis, four times higher respect to womenwithout post-coital infections. In the group of patients withpost-coital urinary infection we found constipation, recurrent UTI,and irregular menstrual cycle rate more common.
Our study showsthat comparing sexually active women in a childbearing age, withoutspecific risk factors for pyelonephritis, more common associated riskfactors was the post-coital urinary infections. In these patients wefound a higher rate of constipation, recurrent UTI, and irregularmenstrual cycle.
References: 1. Curr Opin Infect Dis. 2016Feb;29(1):80-5

Table1. Population of women with pyelonephritis


Post-coitalUTI

Nonpost-coital UTI

Meanage (range)

34.1%(18-45)

28.3%(17-45)

Constipation

60%(6)

15.4%(2)

Irregularmenstrual cycle

60%(6)

23.1(3)

RecurrentUTI

80%(8)

23.1(3)

Propervaginal hygiene after intercourse

80%(8)

84.5%(11)

Vaginaldryness

40%(4)

38.5%(5)