Overview
A two-arm randomized control trial evaluating rates of urinary tract infection in post-menopausal women on vaginal estrogen with recurrent urinary tract infections.
Description
There is a critical need for low-cost, non-antibiotic interventions that are feasible for patients to utilize for risk reduction and prevention of recurrent urinary tract infections (UTIs). The current most effective non-antibiotic prophylaxis for recurrent UTI is vaginal estrogen; however, approximately 50% of women will continue to experience UTIs. The investigators propose a randomized control trial of postmenopausal women on vaginal estrogen with the diagnosis of recurrent UTIs to evaluate a novel post-defecation hygienic strategy utilizing a 2% chlorhexidine perineal lavage. Participants will be randomized to either a 2% chlorhexidine perineal lavage or a water lavage. Study participants will be followed for up to 6-months, and UTIs will be tracked with culture proven samples throughout study participation.
Eligibility
Inclusion Criteria:
- Post-menopausal female between age 55 and 89
- No post-menopausal bleeding
- Diagnosis of recurrent urinary tract infection (UTI) in the electronic health record or as two culture proven UTIs in 6 months or three culture proven UTIs in 12 months
- At least one UTI in the 6 months prior to entering the study
- Asymptomatic for UTI symptoms at the time of enrollment.
- On vaginal estrogen therapy for at least 6 weeks prior to enrollment
- Ready access to email and internet
Exclusion Criteria:
- Recent prophylactic antibiotic use (washout period of 4 weeks)
- Neurogenic bladder
- Diagnosis of urinary retention
- Uncorrected Stage III-IV prolapse
- Indwelling catheter or need for intermittent self-catheterization
- History of complicated UTIs
- History of interstitial cystitis or bladder pain syndrome
- History of fecal incontinence/accidental bowel leakage
- Greater than 14 bowel movements per week
- Non-English speaking
- Allergy to chlorhexidine gluconate
- Inability to utilize vaginal estrogen therapy
- Recent urogynecological or urologic surgery (<12 weeks)