Psychosocial burden of recurrent uncomplicated urinary tract infections

Abstract

Introduction: Urinary tract infections (UTI) are a leading cause of bacterial infections in women. Despite acute treatment, 30-50% of women who have a UTI will experience a recurrence within 6-12 months. In this review, the focus will be on the personal psychosocial impacts of recurrent UTI. Methods: A PubMed/MEDLINE literature search was carried out from 2000 to 2020 in order to identify any recent high-quality meta-analyses or systematic reviews on these topics. Results: One systematic review was found appropriate for this manuscript. Concerning impact on quality of life (QoL) and daily activities, a reduced quality of both intimate and social relationships, self-esteem, and capacity for work was found due to recurrent UTI. Social function was substantially more reduced than physical function. In one study, the greatest reduction overall was in mental role functioning, whereas in another study, mental health reductions were not substantially greater than those of physical health. About one third of women suffered from UTI very often or often after sexual intercourse, and more than half of the patients stated that sexual relations were negatively influenced by UTI. Data from the GESPRIT study suggest that prophylaxis for recurrent UTI is underutilized, because less than 40% of the study population were offered prophylaxis after experiencing three UTI per year, despite all surveyed participants being willing to undertake at least one of the prophylactic measures listed in the survey. Conclusions: Little data on the psychosocial impact of recurrent UTI are available. Therefore, future studies must also incorporate QoL assessments as key outcome measures.

Keywords: antibiotic prophylaxis; behavioral modification; immunoactive prophylaxis; mental health; psychosocial impact; quality of life; recurrent urinary tract infections; sexual function; treatment; women.

Table 1. Recurrent episodes per urinary syndrome by sex and age group [5]

Table 2. SF-36 multi-item scales in recurrent UTI patients in Singapore compared with age- and gender-adjusted population norms (n=1,349)

Figure 1. Proportion of recurrent UTI patients with normal to severe anxiety/depression according to Total Hospital Anxiety and Depression score at baseline and following six months of prophylaxis (principally with OM-89), analysis population N=575 [24]