{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T20:28:53Z","timestamp":1758054533718,"version":"3.44.0"},"reference-count":24,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,7,11]],"date-time":"2024-07-11T00:00:00Z","timestamp":1720656000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>To quantify and compare recurrent urinary tract infection costs between 1 year before and 1 year after electrofulguration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Following IRB approval, a well\u2010characterized cohort of non\u2010neurogenic women with &gt;3 symptomatic urinary tract infections\u00a0(UTIs)\/year, a negative upper and lower urinary tract evaluation, and inflammatory bladder lesions (cystitis) on office cystoscopy who underwent fulguration of these lesions was analyzed. Cost of visits, imaging, labs, and medications were summed for 1\u2010year pre\u2010 and post\u2010fulguration using the Medicare Physician Fee Schedule, local pharmacy pricing, and institutional expenses. Before fulguration, all patients underwent clinic visit, noninvasive flow study, and flexible cystoscopy, and post\u2010fulguration, 6\u2010week follow\u2010up visit and 6\u2010month cystoscopy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ninety\u2010three\u00a0women met study criteria (mean age 64), with 100% 1\u2010year follow\u2010up. Before fulguration, 73% of patients used daily antibiotic suppression, 6% self\u2010start antibiotics, and 5% postcoital prophylaxis. Some also used vaginal estrogens (17%), urinary analgesics (13%), and cranberry or <jats:sc>d<\/jats:sc>\u2010mannose supplements (7%). At 1 year post\u2010fulguration, 82% had 0\u20131 infections and no cystoscopy evidence of cystitis, while 14% required additional fulguration for new cystitis sites and recurrent infections. Patients had on average 0.7 infections in the 1\u2010year post\u2010fulguration, which was significantly lower than pre\u2010fulguration (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Mean 1\u2010year pre\u2010fulguration cost was $1328 (median $1071, range $291\u2013$5564). Mean 1\u2010year post\u2010fulguration cost was $617 (median $467, range $275\u2013$4580). On average, post\u2010fulguration costs were $710 lower than pre\u2010EF (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>For women with antibiotic\u2010refractory recurrent urinary tract infections and cystoscopy evidence of cystitis, fulguration was associated with a significant reduction in UTI\u2010related costs in the 1\u2010year post\u2010fulguration.<\/jats:p><\/jats:sec>","DOI":"10.1002\/nau.25545","type":"journal-article","created":{"date-parts":[[2024,7,11]],"date-time":"2024-07-11T05:55:41Z","timestamp":1720677341000},"page":"1948-1955","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparing costs associated with management of antibiotic\u2010recalcitrant recurrent urinary tract infections for one year pre\u2010 and post\u2010electrofulguration"],"prefix":"10.1002","volume":"43","author":[{"given":"Shivani","family":"Gaitonde","sequence":"first","affiliation":[{"name":"Department of Urology University of Texas Southwestern Medical Center Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy","family":"Kuprasertkul","sequence":"additional","affiliation":[{"name":"Division of Urologic Surgery Washington University School of Medicine St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alana L.","family":"Christie","sequence":"additional","affiliation":[{"name":"Simmons Comprehensive Cancer Center Biostatistics, Southwestern Medical Center, University of Texas Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feras","family":"Alhalabi","sequence":"additional","affiliation":[{"name":"Department of Urology University of Texas Southwestern Medical Center Dallas Texas 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