Consider Sexually Transmissible Pathogens

Letters to the Editor The Diagnosis, Treatment, and Prevention of Recurrent Urinary Tract Infection by PD Dr. med. Guido Schmiemann; PD Dr. med. habil. Jennifer Kranz, FEBU, MHBA; Dr. med. Falitsa Mandraka, MME; Prof. Dr. med. Sören Schubert; Prof. Dr. med. Florian Wagenlehner; and Prof. Dr. med. Ildikó Gágyor in issue 11/2024

My comment on this very detailed article (1)—so important for medical practice—is that one aspect of recurrent urinary tract infections was omitted completely. This is the importance of sexually transmitted pathogens, which in my opinion and in view of 40 years’ experience in medical practice, were not considered. It is of substantial importance in the group of sexually active patients (sometimes also geriatric patients) to take a swab for chlamydia, mycoplasma, and ureaplasma, although many gynecologists and urologists consider ureaplasma as pathogenic only to a vanishing degree or not at all. Its common asymptomatic occurrence does not prove that these pathogens cannot occur as co-factors or initiating factors to recurrent urinary tract infection. By stringently detecting the named pathogens and their treatment over years I was able to lower the number of patients with chronic urinary tract infections in my practice considerably. After all, the detection rate of sexually transmissible pathogens and their eradication (in the sexual partner too) exceeded 70%. This is certainly only a minor aspect in the diagnostic evaluation and treatment of recurrent urinary tract infections, which, however, can be of major importance for affected patients.

DOI: 10.3238/arztebl.m2024.0164

Reinhard Laszig

Facharzt für Urologie, Kiel

Conflict of interest statement

The author declares that no conflict of interest exists.

References

1. Schmiemann G, Kranz J, Mandraka F, Schubert S, Wagenlehner F, Gágyor I: The diagnosis, treatment, and prevention of recurrent urinary tract infection. Dtsch Arztebl Int 2024; 121: 373–82.