P0147 Re-evaluation of the acute cystitis symptom score in multinational settings

Introduction & Objectives: The diagnose of acute uncomplicated cystitis (AC) based on typical symptoms is becoming more reasonable and may serve as reliable criteria for a cost-effective strategy, especially at the time of challenges because of COVID-19 pandemic. We aimed to reevaluate the psychometric characteristics and diagnostic values of the Acute Cystitis Symptom Score (ACSS), a self-reporting questionnaire for clinical diagnose of AC in the multinational cohort of respondents. Materials & Methods: The current trial was designed as a case-control study. We retrospectively analysed the selected data from the ACSS multinational database, consisting of the information from 2078 female respondents from 13 different countries. The “diagnostic” part of the ACSS contains 6 items for “typical” symptoms including severity, such as frequency, urgency, dysuria, suprapubic pain, incomplete bladder emptying, and hematuria. The “differential” domain contains 5 items on symptoms such as flank pain, abnormal vaginal and urethral discharge, and elevated body temperature/fever. The “QoL” domain contains 3 items for quality of life. Special underlying conditions, such as menopause, premenstrual syndrome, pregnancy, and diabetes mellitus are given in the “Additional” domain of the ACSS. Diagnostic values of the ACSS cut-off value (a summary score of 6 and more by the “typical” symptoms) were assessed via calculations of sensitivity, specificity, positive and negative predictive values (PPV, NPV), Youden's index, test accuracy, and area under the receiver operating characteristic curve (AUC). Psychometric abilities were calculated via the coefficient of Cronbach's alpha. Results are presented by average estimates and 95% confidence intervals (CI). Results: The ACSS is linguistically and clinically validated in 11 different languages. Data of 1535 respondents from 13 countries (566 Controls and 969 Patients with AC) with the mean age of 39.7±16.6 were included in the analysis. Sensitivity and specificity of the ACSS cut-off value were 0.82 (0.79;0.84) and 0.92 (0.90;0.95) respectively. PPV and NPV were 0.95 (0.93;0.96) and 0.75 (0.72;0.78) respectively. Youden's index was 1.74 (1.71;1.77) with the test accuracy of 0.86 (0.84;0.87). AUC for the “Typical” domain was 0.93 (0.92;0.95). The Cronbach's alpha for the “Typical” symptoms was 0.88 (0.87;0.89). Conclusions: The ACSS has proven its excellent validity and high diagnostic abilities in multinational settings. It can now be recommended as the diagnostic tool for international, multi-centre, multinational clinical and epidemiological studies, in clinical practice or for self-diagnosis for women with symptoms of AC.

[Viral infections in urology]. / Virusinfektionen in der Urologie.

INTRODUCTION: The COVID (coronavirus disease 2019) pandemic has shown impressively that infectious diseases can have an enormous impact on the healthcare system and beyond. In the specialty of urology, patients present in daily practice with viral infections that are associated with numerous diseases. METHODOLOGY: The aim of this review is to describe viral infections relevant for urology, and in particular to emphasize vaccination prevention. A selective literature search was carried out on the subjects of "COVID and urology", "urogenital viral infections", "viral urological infections in transplant medicine", and "vaccination prevention of viral diseases". RESULTS: Coronaviruses have already caused two local epidemics: SARS (severe acute respiratory syndrome) epidemic and MERS (Middle East respiratory syndrome) epidemic. The fact that the SARS-CoV­2 (SARS coronavirus 2) disease is contagious even without symptoms has essentially led to the rapid spread and global pandemic. A large number of viruses, which can also induce viremia, have been detected in the ejaculate and are thus associated with a possible urogenital infection. These include the mumps virus, Coxsackie viruses or enteroviruses, among others. It has also been shown that a Zika virus infection can also be sexually transmitted via the sperm as a carrier. Viruses therefore also play an important role in reproduction. When performing kidney transplants, urologists are often confronted with viral infections. The most effective weapon against viruses is prevention by vaccination. CONCLUSION: In terms of ethiopathogenesis, the genitourinary tract is most often affected by viruses, in the context of viremia or through reactivation due to immunosuppression. Immunomodulation and vaccination prophylaxis play a leading role in therapy.