E-Posters-10163

10163_Wolff
Pdf Summary
A study conducted by the Department of Obstetrics & Gynecology and Urology at Loyola University Chicago Stritch School of Medicine aimed to correlate self-reported symptoms of urinary tract infection (UTI) with examination findings of myofascial pain of the pelvic floor (MPS) and evaluate patient characteristics associated with MPS. The retrospective analysis found that symptoms commonly associated with UTI, such as urinary urgency, frequency, dysuria, and pelvic pain, were actually associated with the presence of pelvic floor myofascial pain, while only 6% of patients had a culture-proven UTI. These findings highlight the importance of considering pelvic floor myofascial pain in the differential diagnosis of these symptoms.<br /><br />The study included adult women seeking urogynecological care who reported lower urinary tract symptoms. Demographic and physical examination data, including pelvic organ prolapse and findings of pelvic floor myofascial pain, were collected and analyzed using SPSS. The results showed a significantly higher proportion of patients with myofascial pain on examination among those who reported symptoms of dysuria, pelvic pain, urinary urgency, or frequency. There was no association between myofascial pain and the reported symptom of urinary urgency incontinence or the presence of a positive UTI by culture. It is worth noting that urine culture may be positive in less than 50% of patients presenting with UTI symptoms.<br /><br />The study concludes that antibiotic use for UTIs has risks such as the emergence of drug resistances, and the differential diagnosis for UTI includes noninfectious causes such as interstitial cystitis/painful bladder syndrome (IC/PBS). Women with IC/PBS often have high rates of pelvic floor dysfunction, and those with hypertonic pelvic floor muscles may experience voiding dysfunction.<br /><br />A multivariate analysis of patient characteristics associated with MPS found that age, pelvic pain, dysuria, and urgency or frequency were independent predictors of pelvic floor myofascial pain. Women under 50 years old, those with pelvic pain, dysuria, or urgency or frequency symptoms, had higher odds of pelvic floor myofascial pain.<br /><br />Overall, this study emphasizes the need to consider pelvic floor myofascial pain in patients presenting with UTI symptoms, as it may often be the underlying cause. It also suggests that urine culture alone may not provide an accurate diagnosis for all individuals experiencing lower urinary tract symptoms.
Keywords
urinary tract infection
myofascial pain
pelvic floor
symptoms
urinary urgency
frequency
dysuria
pelvic pain
culture-proven UTI
urogynecological care