What Is Electrocautery and Why It May Be the Key to Recurrent UTIs

(HealthDay News) — For some people elderly womenthis recurrent urinary tract infection and antibiotic Drugs typically used to combat them have become a part of life, but a new study offers a way new treatments This can provide relief.

is called electrocauteryhe minimally invasive surgery basically Burn and remove inflamed and infected tissue in the bladder. Studies have found that it works for several women with this problem.

The corresponding author of the study, Ph.D. Philip ZimmernDirector of the John and Felecia Cain Center for Bladder Health at UT Southwestern Medical Center in Dallas, he said he was interested in finding a solution because he saw so many patients repeatedly taking antibiotics to treat bladder infections before being referred to him.

“It was a little confusing. I thought, ‘Where are these infections coming from?'” Zimmern said.

Zimmern was inspired to try electrocautery after reading the work of another researcher who found in animal studies that infection had invaded the surface of the bladder, allowing bacteria to stick to deeper layers. after that, These bacteria are able to persist in the bladder because they are protected by a biofilmhe explained.

“Once we showed that the bacteria were present, that led to the idea that electrocautery could actually be the ultimate treatment for these patients,” Zimmern said.this glare been used in the past Removal of bladder tumorsAccording to the National Institutes of Health.

For the study, researchers reviewed the medical records of 96 postmenopausal women who received electrocautery therapy for recurrent urinary tract infections (UTIs) between 2006 and 2012.

people think that About 72% of women received successful treatment. This means they had no more than one urinary tract infection per year during follow-up. Another 22% have fewer than three urinary tract infections per year. About 6% were unchanged.

Only about 5% of women still take antibiotics The rate continued to rise after the last follow-up visit, compared with 74% before electrocautery, the report said.

The issue of concern is Taking antibiotics continuously or repeatedly For infections, they accumulate over time drug-resistant strains, which can make UTIs more difficult to treat. Sometimes this can lead to a dangerous blood infection called sepsis. Researchers say surgery to remove the bladder is sometimes necessary.

“There’s a complex relationship between the types of bacteria that invade the bladder. That’s what we need to figure out. The bacteria are different and their ability to stick to tissue is different,” Zimmern said. “What’s interesting about this story is that half of the women were not infected.”

Another study Zimmern is involved in is investigating what happens to women who don’t have these chronic infections and how to protect them, but that’s still ongoing.

After electrocautery, doctors have several tools to help prevent bacteria from re-entering the bladder.These may include hormone creams and probiotics, Zimmern said.

The findings are published in the October issue of the journal Journal of Urology. Dr. Louis Cavosi, chief of urology at Northwell Health Center in New Hyde Park, N.Y., expressed reservations about whether the procedure should be recommended to women over standard care.

“Does it deserve more research?Yes, you deserve it, but it’s never a panacea or standard of careCavosi said.

Kavosi explained that postmenopausal women may struggle with recurring urinary tract infections due to changes in estrogen levels, which help keep pelvic, vaginal and urethra tissue strong. As estrogen decreases, tissue becomes thinner, he said.

Someone may take antibiotics for a UTI, but the natural barrier against infection may take longer than a course of antibiotics to repopulate and prevent bacteria from adhering to the surface of the bladder.

“What happens if bacteria get in when that layer is weakerand then they develop another infection, called a cluster infection,” Kavosi said.

Cavosi pointed out Study volunteers also took long-term antibiotics after electrocautery And wonder if this plays a disproportionate role in treatment.

She suggests some alternatives for women with recurring urinary tract infections.

“Some of them are very simple. One is drinking a lot of water,” Kavosi said. The study examined cranberry products, including cranberry juice.

He adds that estrogen cream applied to the opening of the urethra three times a week can help tissue grow but is not absorbed throughout the body. “The fourth approach is to take long-term, low-dose antibiotics for about four to six weeks,” Kavosi said. “All these methods have proven useful. I think this makes academic sense.Kavosi said of electrocautery.

More information. The U.S. Centers for Disease Control and Prevention has more information about urinary tract infections.

Sources: Philippe Zimmern, MD, Professor of Urology, Director of the John and Felecia Cain Bladder Health Center, University of Texas (UT) Southwestern Medical Center, Dallas; Louis Kavoussi, MD, Director of Urology, Northwell Health, New York, NY Professor of Urology, Zucker School of Medicine, Hyde Park; Journal of Urology, October 2023.

*Cara Murez. HealthDay Reporter © The New York Times 2023