Abstract
OBJECTIVE: To investigate the natural history of recurrent urinary tract infections in women of childbearing age and to gain insight into their consequences and the ideas of the patients. DESIGN: Historical cohort-study and interviews with patients. METHOD: All non-pregnant women in the age-range 15-49 years who had had > or =2 urinary tract infections in one year in the period 1990-1994 were selected with the aid of the 'Continuous morbidity registration' (CMR) from four general practices in Nijmegen, The Netherlands. The patients' files were used for supplementary information. The risk of recurrence was calculated by the Kaplan-Meier method. Patients between the ages of 15 and 35 who had had > or =2 urinary tract infections in one year in the period 2002-2003 were interviewed. RESULTS: Of the 115 women in the CMR-study group, 70 (61%) were younger than 30 years. The median duration of follow-up was 10.0 years. The risk of a new recurrence within one year was 56%; the chance of remaining free of recurrences for two years was 33%. The 115 patients underwent a total of 630 urinary tract infections during the study period; an antibiotic was prescribed every time. 2 of the 115 patients developed pyelitis/pyelonephritis. An underlying abnormality was found in one of the 12 patients that were referred. Of the 21 women that were interviewed, 8 (38%) stayed away from school or work during the infection, depending on the symptoms. Of the 18 women that were sexually active, 13 (72%) did not want to have sex during the infection. 10 of the 21 women (48%) were concerned about possible complications. A decreased resistance, cold on the bladder, stress, menstruation and improper vaginal hygiene were most frequently mentioned by the women as the cause ofthe urinary tract infections. When women with recurrent urinary tract infections consult a general practitioner, the latter can discuss their unjustified concerns and attributions.
