Do variations in labial anatomy have an effect on recurrent urinary tract infection?

• Published in: International Urogynecology Journal 2020-10, Vol.31 (10), p.2129-2136
• Main Authors: Aydın, Arif, Atılgan, Adeviye Elçi, Sönmez, Mehmet Giray, Sönmez, Leyla, Boğa, Mehmet Salih, Balasar, Mehmet
• Format: Article
• Language: English
• Subjects: Gynecology; Medicine; Medicine & Public Health; Original Article; Urinary tract infections; Urogenital system; Urology; Vagina
• ISSN: 0937-3462; 1433-3023
• DOI: 10.1007/s00192-020-04310-8

Introduction and hypothesis Variations in labial anatomy may constitute a risk factor for vaginal pH increase and recurrent UTIs. Our objective in this study was to show the effects of variations in labial anatomy on vaginal pH and recurrent UTI. Methods A total of 331 non-menopausal and sexually active patients between the ages of 18 and 50, meeting recurrent urinary infection criteria and not meeting exclusion criteria were included in the study in group 1, the infection group, and 440 patients without recurrent UTI were included in group 2, the control group. Vaginal pH values of the participants were measured. Labia minora were classified as labial anatomy based on the Banwell classification. Predisposing factors and demographic data were also questioned, measured, recorded, and compared. Results A significant difference was detected in labial anatomy between groups 1 and 2 based on the Banwell classification. Banwell type 3 in group 1 (76%) and Banwell type 2 in group 2 (55%) were observed to be significantly higher. There was a significant difference in right and left vertical and horizontal dimensions of the labia minora between the two groups. It was also observed that the vaginal pH was significantly more alkaline in group 1 compared with group 2 (6.11 vs 4.48). Conclusion Although there are many causes of recurrent urinary tract infections, this study showed that vaginal pH imbalance and labia minora anatomy in the lower third prominence based on the Banwell classification (type 3) were among the most important causes. Thus, we think that the vaginal anatomy should be evaluated in recurrent UTI patients.