Persistent urinary tract infection despite targeted antibiotics: the role of surgical intervention in encrusted cystitis caused by Corynebacterium urealyticum

Elderly or multimorbid patients with recurrent or refractory urinary tract infections should be evaluated for <i>Corynebacterium urealyticum</i>, especially if they have had previous urological procedures, chronic catheterization or persistent bladder inflammation.Mucosal encrustation and infectious calculi function as chronic foci of infection, reducing the effectiveness of systemic antibiotic therapy alone and contributing to persistent or relapsing symptoms.A multimodal approach, including accurate microbiological identification, targeted antimicrobial therapy and endoscopic removal of encrustations and calculi, is needed to organize the best management of encrusted cystitis.