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Posttoilet rinsing predicts prolonged cystitis and antibiotic use in adult women with uncomplicated acute cystitis

Kian‑Woei Chonga,b, Ya‑Hui Wanga,b, Bing‑Juin Chianga,b*

aMedical Research Center, Cardinal Tien Hospital, and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan, bDepartment of Urology, Cardinal Tien Hospital, New Taipei, Taiwan
 

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Open Access funded by Buddhist Compassion Relief Tzu Chi Foundation

 

Abstract
 
Objectives: We retrospectively investigated whether the habit of posttoilet rinsing as a hygiene method is a predisposing factor for prolonged pyuria and extended antibiotic use in females with uncomplicated acute cystitis as well as analyzed the clinical characteristics. Materials and Methods: Adult female patients with urinary tract infections (UTIs) were retrospectively reviewed between October 2021 and September 2022 at a regional hospital in Taiwan. Patients with uncomplicated acute cystitis were included. Exclusion criteria included patients younger than 18 years of age, those with vaginal discharge or irritation, fever, functional or anatomical abnormalities of the genitourinary tract, an indwelling urinary catheter, hormone replacement therapy, pregnancy, or other complicated UTIs. The collected information included age, self‑reported comorbidities, habits of posttoilet rinsing as a hygiene method, antibiotic use, urine analysis, and pathogens obtained in urine cultures. Results: In total, 823 women with UTI were identified. Of these, 133 were diagnosed with uncomplicated acute cystitis. Further, 35 patients had the habit of posttoilet rinsing (habit group; mean age, 60.54 ± 15.97 years). The control group included 98 patients without this habit (mean age, 53.26 ± 17.18 years) (P = 0.03). The percentage of cases wherein cystitis resolved within 1 week was significantly higher in the control group (61.86%) compared to that in the habit group (25.71%, P = 0.0002). The urine culture positivity rate between the control and habit groups was not significantly different (57.14% vs. 40.0%, P = 0.0812). The posttoilet rinsing habit was the only predictor of prolonged cystitis and antibiotic use in both univariable and multivariable analyses. Conclusion: These results suggest that the habit of posttoilet rinsing may prolong the duration of uncomplicated acute cystitis.

 

Keywords: Acute cystitis, Female, Posttoilet, Rinsing

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