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Dysuria provides clinical hint of urinary tract infection in women

04 Oct 2017

Dysuria signals the presence of urinary tract infection (UTI) better than urinary frequency or urgency or both in women seeking urogynaecologic care, a study suggests.

The study included 150 female patients (mean age 62.3 years; mean body mass index, 29.3 kg/m2) who completed the validated UTI Symptom Assessment questionnaire. Transurethral catheterized urine samples were examined for UTI, the primary outcome measure.

UTI diagnosis was defined in three ways: a nonculture-based UTI diagnosis (self-report) and culture-based UTI diagnoses, including standard urine culture (≥104 colony-forming units [CFU]/mL) and enhanced quantitative urine culture (≥10 CFU/mL) of any uropathogen.

Results showed that the presence of the urinary symptoms of frequency and urgency differed only to a certain extent between UTI-positive and UTI-negative patients (self-report, p=0.005 and p<0.001, respectively; standard urine culture, p=0.038 and p=0.044; enhanced quantitative urine culture, p=0.059 and p=0.098).

On the other hand, the presence of dysuria (pain or burning) during urination was markedly more common among UTI-positive patients for all UTI definitions (self-report, p<0.001; standard urine culture, p<0.001; enhanced quantitative urine culture, p=0.010).

Additionally, compared with patients who did not report dysuria, those who did showed higher severity and bother scores for all other urinary symptoms assessed by the UTI Symptom Assessment questionnaire (frequency, p=0.001; urgency, p=0.006; dysuria, p<0.001).

The present data suggest that the presence of frequency and urgency of urination does not confirm a culture-based UTI diagnosis, researchers said.

“Instead, clinicians can more readily detect UTI using the presence of dysuria, which more effectively discriminates UTI-positive and UTI-negative individuals, regardless of the culture-based method used to diagnose UTI,” they added.

The use of dysuria as a key UTI symptom thus warrants further assessment, researchers said.

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Despite comparable efficacies, triamcinolone injections appear to be slightly superior over 5-fluorouracil injections for inducing keloid remission, a recent trial has found.
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