CLINICAL STUDY OF RECURRENT BACTERIAL CYSTITIS

Abstract

Surveying retrospectively the clinical records of patients who visited us for simple bacterial cystitis, we tried to define the term “recurrent” of so-called recurrent cystitis from the side of agents. As a concequence of the survey, our definition for the term “recurrent” resulted in: each case of re-infection within 5 months after effective treatment of the anteceding infection or of repeated infections 3 times or more in one year. And therefore, the treatment for them was considered effective in preventing recurrence when there was no recurrence for over 6 months.
As to the incidence of bacterial cystitis, particularly in females, it was found that in single episode cases, the peak appeared in the 31 to 40 age group and was next highest between 41 and 50, while the average age of those suffering from recurrent cystitis was over 40 years, and still more, it was repeatedly observed by laboratory examinations that the external genitalia was a habitat of enterobacteria common with both infected urine and normal anal region in the patient with recurrent cystitis. Then we presumed that the peak of the incidence in single episode cases would closely be related to their sexual life as generally accepted, but the next highest in the 41 to 50 age group would not only be related to their sexual life but to the acquired abnormal or pathogenic flora of their external genitalia, again which would possibly be reflecting the disposition easily falling in urinary infection in the person who belongs to this age group.
From the viewpoint above-mentioned, we tried out sterilization of the vaginal mucosa associated with a conventional treatment for urinary infection with the hope of preventing recurrence, and some 46% effectiveness for preventing recurrence over 6 months was achieved. Next to be tried out was reconstruction of the normal vaginal flora which consisted of vaginal sterilization and artificial colonization of lactobacilli on vaginal mucosa, and this method proved so effective that nearly 100% prevention of recurrence was achieved in patients who carried the bacilli.
It is deemed that this principle for preventing recurrent cystitis would also be applicable to prevention of recurrence of upper urinary tract infection in some female patients.