Recurrent urinary tract infections in postmenopausal women

To evaluate factors associated with recurrent urinary tract infection (UTI) in postmenopausal women, we conducted a case-control study comparing 149 p ostmenopausal women referred to an infectious diseases outpatient clinic wh o had a history of recurrent UTI (case patients) with 53 age-matched women without a history of UTI (control patients). Each woman completed a questio nnaire providing demographic data, history and clinical characteristics of prior infections, and information regarding risk factors for UTI. In additi on, each patient underwent a gynecologic evaluation, renal ultrasound and u rine flow studies, and blood group and secretor status testing. Three urolo gic factors-namely, incontinence (41% of case patients vs. 9.0% of control patients; P < .001), presence of a cystocele (19% vs. 0%; P < .001), and po stvoiding residual urine (28% vs. 2.0%; P = .00008)--were all strongly asso ciated with recurrent UTI. Multivariate analysis showed that urinary incont inence (odds ratio [OR], 5.79; 95% confidence interval [CI], 2.05-16.42; P = .0009), a history of UTI before menopause (OR, 4.85; 95% CI, 1.7-13.84; P = .003), and nonsecretor status (OR, 2.9; 95% CI, 1.28-6.25; P = .005) wer e most strongly associated with recurrent UTI in postmenopausal women. Pros pective studies are needed to confirm these observations and to develop app roaches for prevention.