Association of chronic urinary symptoms in women and Ureaplasma urealyticum

Objectives. To determine the incidence of Ureaplasma urealyticum in women e xperiencing chronic urinary symptoms and to determine whether antibiotic th erapy targeting these organisms is effective. Methods. Forty-eight consecutive women referred to our academic medical cen ter for chronic voiding symptoms and possible interstitial cystitis underwe nt urologic evaluation, including culture screening for U. urealyticum and Mycoplasma hominis. Patients with positive cultures were treated with a 1-g dose of azithromycin; persistent infection was treated with 7 days of doxy cycline, ofloxacin, or erythromycin. Patients reported symptom severity (0, mild; 3, severe) and voiding frequency before and 6 months after treatment . Results. Positive cultures were obtained in 23 (48%) of 48 patients; 22 had U. urealyticum and 1 had M. hominis. All had negative cultures after treat ment. The mean symptom severity score improved with treatment (2.2 to 0.7, P <0.001), and the mean urinary frequency decreased (9.2 daily to 6.8 daily , P <0.001). Two of the 23 patients experienced no improvement; one had det rusor instability and the other had medically related urinary frequency. Of the 25 patients with negative cultures, interstitial cystitis was establis hed in only 9 (19% of the total sample). Conclusions. Although often overlooked or improperly treated, U. urealyticu m and M. hominis infections may account for a large proportion of unexplain ed chronic voiding symptoms. Culture and treatment should be considered bef ore pursuing more costly and invasive tests. UROLOGY 55: 486-489, 2000. (C) 2000, Elsevier Science Inc.