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NEUROLOGY
& FEMALE UROLOGY
Prevalence
of Ureaplasma urealyticum and Mycoplasma hominis in women with chronic
urinary symptoms
Baka S, Kouskouni E, Antonopoulou S, Sioutis D, Papakonstantinou M, Hassiakos
D, Logothetis E, Liapis A
Department of Biopathology, Aretaieion Hospital, University of Athens,
Athens, Greece
Urology. 2009; 74: 62-6
- Objectives:
To assess the prevalence of Ureaplasma urealyticum and Mycoplasma hominis
in women experiencing chronic urinary symptoms.
Methods: Urine, vaginal, and urethral samples obtained from 153 women
presenting with chronic voiding symptoms were tested for the presence
of pathogens including U. urealyticum and M. hominis. Patients with
positive cultures for Mycoplasma were treated with a single dose of
1 g azithromycin and followed up 1 month after therapy. Patients with
persistent infection received 100 mg doxycycline orally, twice daily
for 7 days, according to the results of the susceptibility test. The
patients were asked to rate the severity of their symptoms at their
initial visit and after treatment.
Results: U. urealyticum was detected from > or =1 site in 81 women
(52.9%), and M. hominis was detected in 5 patients (3.3%), always in
association with U. urealyticum. At follow-up, 77 patients (95.1%) initially
positive for Mycoplasma had negative cultures; the cultures of 4 (4.9%)
remained positive for U. urealyticum and became negative after the second
therapeutic regimen. A significant improvement in all symptoms was observed
in women with positive cultures for Mycoplasma after therapy.
Conclusions: A high prevalence of U. urealyticum was observed in women
with unexplained chronic voiding symptoms. Testing for the presence
of U. urealyticum and M. hominis in the urogenital tract could prove
valuable for the management of a significant percentage of chronic urinary
symptoms in women through appropriate treatment.
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Editorial
Comment
The authors present an excellent paper associating the presence of
urinary tract infection with urinary symptoms. They denoted that with
the appropriate diagnosis and therapy urinary symptoms would resolve.
The authors noted that the presence of organisms usually associated
with vaginal colonization in the urinary tract may represent an infection
causing the urinary symptoms and that appropriate therapy of same
with susceptibility testing would resolve these symptoms. This dogmatic
approach to therapy helps reaffirm the need for appropriate and diligent
clinical diagnosis and therapy in this patient population. It further
bolsters the empirical approach previously described by Burkhard et
al. (1). Both discuss the consideration for treatment of the sexual
partner. It is hoped that future resistance patterns will not lesson
the effectiveness of doxycycline, the antibiotic both reports found
to be efficacious with this patient diagnosis.
Reference
- Burkhard
FC, Blick N, Hochreiter WW, Studer UE: Urinary urgency and frequency,
and chronic urethral and/or pelvic pain in females. Can doxycycline
help? J Urol. 2004; 172: 232-5
Dr.
Steven P. Petrou
Professor of Urology, Associate Dean
Mayo School of Graduate Medical Education
Jacksonville, Florida, USA
E-mail: petrou.steven@mayo.edu
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