Generalized Symptoms In Adult Women With Acute Uncomplicated Lower Urinary Tract Infection: An Observational Study

Anders Baerheim, MD, PhD, Asbjørn Digranes, MD, Roland Jureen, MD, Kirsti Malterud, MD, PhD

In This Article

Abstract and Introduction

Several generalized symptoms in acute lower urinary tract infection (UTI) have previously been identified in a qualitative study. The aim of the present study was to explore the frequency and distribution of generalized symptoms in adult women with acute uncomplicated lower UTI in general practice. A total of 398 women aged 18-87 years consulting for acute dysuria and/or urinary frequency were enrolled in an observational study and filled in a structured symptom questionnaire. A total of 252 of these had bacteriuria (≥ 105 uropathogens/mL). Generalized symptoms occurred frequently: feeling unwell 68%, week and tired 67%, irritable and restless 53%, and hot 52%. Other symptoms were voiding-related symptoms (dysuria 90%, urinary frequency 93%, urge 80%) and local, constant symptoms (pressure in the genital area 73%, suprapubic discomfort 68%). Factor analysis revealed 2 main components of cystitic symptoms: "feeling out of sorts" (generalized symptoms) predominantly found among women aged 50-65 years, and the "distressed bladder" (voiding-related and local, constant symptoms) most often in the group aged 18-35 years. No differences in frequency or degree of symptoms were related to the presence of bacteriuria. In conclusion, generalized symptoms of feeling out of sorts are frequent in adult women with acute uncomplicated lower UTI, and equally frequent in all ages whether the patient shows bacteriuria or not.

Acute uncomplicated lower UTI in otherwise healthy women is one of the most common diseases in general practice. The most frequent symptoms are dysuria and urinary frequency.[1,2]

The clinical diagnosis depends mainly on typical symptoms and, if necessary, leucocyturia at urinalysis.[1,2] Bacterial culture is seldom indicated, and urinalysis may be less important, as typical symptoms (including an abrupt onset of dysuria) have been considered by many as sufficiently diagnostic.[1,2,3]

When the diagnosis is mainly based on the patients' symptoms, knowledge of the experienced symptoms is important for the clinician. The literature traditionally describes symptoms of lower UTI as dysuria, urinary frequency, urge, and suprapubic discomfort.[2,4,5,6] In a recent qualitative study, however, we demonstrated a wide range of different symptoms in patients with acute lower UTI.[7] These were categorized as voiding-related symptoms, local constant symptoms, and generalized symptoms. Generalized symptoms are seldom mentioned in the literature, though some may be familiar to the general practitioner. Until now, nothing is known of their distribution and frequency in women with acute uncomplicated lower UTI.

The aim of this study was, therefore, to explore the range of generalized symptoms in acute, uncomplicated lower UTI in otherwise healthy adult women.


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