URICA Study: Diagnosis and Management of Recurrent Acute Bacterial Cystitis in Women With Urinary Behavioral Therapy

Recurrent cystitis (RC) impacts both individual and societal levels due to the associated antibiotic prescriptions. However, the diagnosis is sometimes made incorrectly. The aim of this study was to evaluate the final diagnosis retained and the effectiveness of specific management through urinary behavioral therapy (UBT) in a cohort of women consulting for urinary tract infections (UTI). This was an observational, retrospective, bi-centric study including women consulting for UTI between March 2019 and August 2024. A total of 255 patients were identified, excluding men and pyelonephritis cases, while including 176 women consulting for RC. In the event of an acquired functional lower urinary tract dysfunction, treatment was managed by means of UBT (voiding volume <400 ml, interval between two voids < 4 h, 24-h voided volume ≥ 1.5 L and ≤ 2 L). A total of 77 patients (45%) had a confirmed diagnosis of RC with no other associated diagnosis. Urethral burning during urination was found in 66 (86%) patients diagnosed with “isolated RC.” Among the patients diagnosed with isolated RC, 52 were followed for 4 months or more, and therapeutic UBT was proposed to 30 of these patients, with complete disappearance of RC in 17 (56.7%) and partial recovery in 11 (36.7%). Among the patients ( n = 109) followed for at least 4 months (median: 7 months), regardless of diagnosis, 92 (84.4%) achieved complete or partial recovery after appropriate management of the pathology. In our cohort, 55% of patients consulting for RC ultimately had an alternative diagnosis. In cases of functional RC, UBT resulted in complete or partial improvement in 93% of the women followed for more than 4 months. Approved by the French Data Protection Authority (CNIL, Commission Nationale de l’Informatique et des Libertés) and registered under number 30802498.