A 9-year audit of the efficacy of diathermy for cystitis cystica

Abstract

The aim of this study was to assess whether cystoscopy with diathermy for cystitis cystica in patients with recurrent urinary tract infection (UTI) is associated with decreased incidence of UTI. A retrospective 9-year audit was performed in a single urogynaecology centre. Patients with proven recurrent UTI and failed conservative therapy underwent cystoscopy with diathermy to cystitis cystica. The number of UTI’s 12- months pre and post cystoscopy was evaluated using women as their own controls with multivariant analysis of cofounding factors. Of 82 patients with recurrent UTI, 47 patients underwent cystoscopy with diathermy to cystitis cystica (median follow up 2 months [interquartile range, IQR6-31, one patient lost to follow up]). Pre-cystoscopy median UTI per annum was 3 per patient (IQR1-4). Post cystoscopy, median UTI for each woman was significantly reduced (median reduction -2[IQR-5-1], mean -2.14[95%CI -2.94, -1.34], P=<0.001). In the subgroup of patients who had previous vaginal mesh repair for prolapse (n=8) there was no significant benefit from diathermy (median reduction - 1.5[95%CI -0.988, 3.988], P=0.197). In conclusion, cystoscopy and diathermy of cystitis cystica was generally associated with significant reductions in UTI’s in the 12 months following diathermy.