A. Lenore Ackerman, MD, PhD, Victoria C. Scott, and Ja-Hong H. Kim, MD, presented “Fear and Frustration Among Women with Recurrent UTIs” for the Grand Rounds in Urology audience in January 2022.
How to cite: Ackerman, A. Lenore, Kim, Ja-Hong H, and Scott, Victoria C. “Fear and Frustration Among Women with Recurrent UTIs.” January 2022. Accessed Jan 2022. https://grandroundsinurology.com/fear-and-frustration-among-women-with-recurrent-utis/
Fear and Frustration Among Women with Recurrent UTIs
In conversation with A. Lenore Ackerman, MD, PhD, Assistant Professor of Urology and Director of Research in the Division of Female Pelvic Medicine and Reconstructive Surgery at the University of California, Los Angeles, Ja-Hong H. Kim, MD, Associate Professor in the Division of Pelvic Medicine and Reconstructive Surgery at the University of California, Los Angeles, and Victoria C. Scott, MD, Associate Program Director of the FPMRS Fellowship at Cedars-Sinai Medical Center, discuss a recent study of the experience of women with recurrent urinary tract infections (rUTIs). Dr. Scott explains that 29 women were recruited to participate in 1 of 6 focus group discussions to investigate the perspective of women suffering from rUTIs. She then lists some preliminary themes from the discussions with the women, including fear of development of antibiotic resistance, widespread knowledge of the collateral damage from antibiotics, concern about taking unnecessary antibiotics, anger at physicians for “throwing” antibiotics at them, a feeling that the medical profession underestimates the impact of rUTIs, a need for research on nonantibiotic options for prevention and treatment, and resentment towards the medical system for not dedicating more research efforts to providing more timely diagnosis. Dr. Scott synthesizes these themes into two emergent concepts: fear about the overuse of antibiotics and frustration at the medical system for not providing alternative treatments or taking rUTI symptoms seriously. Dr. Kim then notes that this initial study has produced two additional studies on the current management of rUTIs that take expert and personal care provider experiences into account. Dr. Ackerman highlights the importance of data capturing that patients are not seeking antibiotics necessarily in the way doctors assume they are, though Dr. Kim does add the caveat that the women in the study were a relatively homogeneous group of college-educated white women. Dr. Ackerman also muses that the attitudes expressed in this study suggest that this population may be interested in a vaccine for rUTIs. Drs. Ackerman, Scott, and Kim conclude by noting that the study made evident the importance to patients with rUTIs of focusing on their experience rather than merely the clearance of bacteria.
For more in-depth discussions and educational features on rUTI, visit our Microbiome & Urologic Infection Learning Center.
About the Authors
Victoria C. S. Scott, MD, is Associate Program Director of the Cedars-Sinai FPMRS Fellowship. She is a fellowship-trained female pelvic medicine and reconstructive surgeon. Dr. Scott attended medical school at UCLA, where she also completed her residency in Urology and her fellowship. After completing fellowship training, she joined the faculty at Cedars-Sinai Medical Center in August of 2019. Since medical school, she has been dedicated to research designed to improve the quality of care delivered to women with urinary tract infections, prolapse, and incontinence.
Dr. Kim is an Associate Professor in the Division of Female Pelvic and Reconstructive Surgery in the Department of Urology at UCLA Health in Los Angeles, California. She received her undergraduate and medical degrees from the renowned BA/MD program at Rice University and Baylor College of Medicine, both in Houston, Texas. She completed a Residency in Urology at the Cleveland Clinic Foundation in Cleveland, Ohio, and received a Fellowship in Female Pelvic Medicine and Reconstructive Surgery at UCLA. Dr. Kim’s clinical interests include neurogenic and non-neurogenic voiding dysfunction, interstitial cystitis, benign prostatic hypertrophy, incontinence, neuromodulation for overactive bladder and urinary retention, vaginal prolapse, genitourinary reconstruction, and recurrent urinary tract infections. Dr. Kim has expertise in pelvic floor reconstruction and robotic and laparoscopic surgery. She aims to use these skills to improve patients’ quality of life and to help them regain physical function. Dr. Kim is involved with numerous professional organizations, including the American Urological Association, the Society of Women in Urology, the Society of Urodynamics and Female Urology, and the American Urogynecologic Society. She is also a reviewer for Neurology & Urodynamics, British Journal of Urology, Journal of Urology, and Urology.
Dr. A. Lenore Ackerman is Assistant Professor of Urology and Director of Research in the Division of Female Pelvic Medicine and Reconstructive Surgery at the University of California, Los Angeles. She was born in Los Angeles, but spent her childhood throughout the US, from southern California to Maine. After settling in New Haven, Connecticut, she earned her degree in Molecular Biophysics and Biochemistry at Yale University. She later completed her PhD in Immunology at Yale, focusing on molecular mechanisms of antigen presentation in dendritic cells. After realizing a desire to pursue translational medicine, she joined the Medical Scientist Training Program at Yale, receiving her MD. She completed her internship in General Surgery and began residency in Urology at the University of California, Los Angeles. Under the mentorship of Dr. Larissa Rodriguez, her research during this residency focused on changes in the central nervous system of an animal model due to interstitial cystitis induced by psychological stress. After the completion of residency, she continued at UCLA as a fellow in Pelvic Medicine and Reconstructive Surgery. Her current research focuses on the role of host-microbe interactions in the etiology of benign lower urinary tract disorders. She specializes in the treatment of incontinence, voiding dysfunction, and pelvic floor disorders.