Definitions of Urinary Tract Infection Used in Interventional Studies Involving Neurourological Patients-A Systematic Review.

Neurourological patients often encounter bacteriuria without any symptoms or may experience symptoms suspicious of urinary tract infections (UTIs). However, there is a lack of guidelines that unequivocally state the definition of UTIs in this specific patient group.

To present all used definitions of UTIs in neurourological patients.

This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Studies were identified by electronic search of Medline, Embase, Cochrane controlled trials databases, and clinicaltrial.gov without a time limitation (last search September 2020) and by screening of reference lists and reviews. The occurrences of the various UTI definitions were counted and the frequencies calculated.

After screening 7164 abstracts, we included 32 studies enrolling a total of 8488 patients with a neurourological disorder who took part in an interventional clinical study. UTI definitions were heterogeneous. The concordance to predefined definitions was low.

Interventional clinical studies rarely report specific definitions for UTIs, and both clinical and laboratory criteria used are heterogeneous. A generally accepted UTI definition for neurourological patients is urgently needed.

Patients suffering from neurological disorders often experience symptoms in their lower urinary tract that resemble urinary tract infections. Furthermore, they can have positive urine cultures without symptoms (the so-called asymptomatic bacteriuria). However, clinical studies rarely report specific definitions for urinary tract infections, and when it is done, they are heterogeneous. A generally accepted urinary tract infection definition for neurourological patients is urgently needed. TAKE  HOME MESSAGE: Interventional clinical studies on neurourological patients rarely report specific definitions for urinary tract infections (UTIs), and both clinical and laboratory criteria used are heterogeneous. A generally accepted UTI definition for neurourological patients is urgently needed.

European urology focus. 2021 Aug 14 [Epub ahead of print]

Andrea M Sartori, Bárbara Padilla-Fernández, Lisette 't Hoen, Bertil F M Blok, David M Castro-Díaz, Giulio Del Popolo, Stefania Musco, Rizwan Hamid, Hazel Ecclestone, Jan Groen, Gilles Karsenty, Veronique Phé, Thomas M Kessler, Jürgen Pannek

Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, Zürich, Switzerland., Department of Urology, Complejo Hospitalario Universitario de Canarias, Universidad de La Laguna, Tenerife, Spain. Electronic address: ., Department of Urology, Erasmus Medical Center, Rotterdam, The Netherlands., Department of Urology, Complejo Hospitalario Universitario de Canarias, Universidad de La Laguna, Tenerife, Spain., Department of Neuro-urology, Careggi University Hospital, Florence, Italy., Department of Neuro-urology, London Spinal Injuries Centre, Stanmore, UK., Department of Urology, Aix Marseille University, Marseille, France., Department of Urology, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Academic Hospital, Sorbonne University, Paris, France., Neuro-Urology, Swiss Paraplegic Center, Nottwil, Switzerland.

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