Korean J Urogenit Tract Infect Inflamm.  2013 Apr;8(1):27-31. 10.14777/kjutii.2013.8.1.27.

Risk Factors of Infectious Complications after Transurethral Prostate Surgery in Patients with Preoperative Sterile Urine

Affiliations
  • 1Department of Urology, Chonnam National University Medical School, Gwangju, Korea. drjsi@yahoo.co.kr

Abstract

PURPOSE
To determine the risk factors of infectious complications after transurethral surgery of the prostate in patients with sterile urine.
MATERIALS AND METHODS
A total of 183 patients who underwent transurethral resection of the prostate or holmium laser enucleation of the prostate were reviewed. All patients had urinalyses and urine cultures preoperatively, on the day of catheter removal, and at two weeks postoperatively. Patients were divided into two groups according to whether preoperative urinalysis showed sterile urine (group I, n=99) or not (group II, n=84). Clinical parameters were compared between the two groups. Univariate and multivariate logistic regression were used for estimation of infectious complications after surgery in group I.
RESULTS
Compared with group II, group I showed younger age, fewer post voided residuals, low prostate specific antigen levels, short-term duration of oral antibiotic therapy, and low incidence of infectious complications (p<0.05). In univariate analysis in group I, age, diabetes mellitus (DM), prostate volume, resection weight, and duration of oral antibiotic therapy showed an association with infectious complications (p<0.05). Factors showing independent association with infectious complications in group I were DM (odds ratio [OR], 7.31; 95% confidence interval [CI], 1.83-29.0; p=0.005), resection weight (OR, 1.03; 95% CI, 1.01-1.06; p=0.039), and duration of oral antibiotics (OR, 0.64; 95% CI, 0.43-0.94; p=0.025).
CONCLUSIONS
Kinds of antibiotics showed no effect on infectious complication, therefore, second generation cephalosporin is recommended for reduction of antibiotic resistance. Clinicians should be aware of the high risk for infectious complication in patients with DM and who underwent large volume resection of the prostate.

Keyword

Urinary tract Infections; Transurethral resection of prostate; Risk factors

MeSH Terms

Anti-Bacterial Agents
Catheters
Diabetes Mellitus
Drug Resistance, Microbial
Humans
Incidence
Lasers, Solid-State
Logistic Models
Methods
Prostate*
Prostate-Specific Antigen
Risk Factors*
Transurethral Resection of Prostate
Urinalysis
Urinary Tract Infections
Anti-Bacterial Agents
Prostate-Specific Antigen

Cited by  1 articles

Antimicrobial Prophylaxis in Transurethral Enucleation and Resection of the Prostate: A Comparison of 1-Day Treatment and More than 2-Day Treatment
Min Seok Kim, Won Jin Cho, Seung Baik, Dong Hoon Lim, Joon Nho, Chul Sung Kim
Korean J Urogenit Tract Infect Inflamm. 2014;9(2):104-110.    doi: 10.14777/kjutii.2014.9.2.104.


Reference

1. AUA Practice Guidelines Committee. AUA guideline on management of benign prostatic hyperplasia (2003). Chapter 1: Diagnosis and treatment recommendations. J Urol. 2003; 170:530–47.
2. Madsen PO, Larsen EH, Dorflinger T. The role of antibacterial prophylaxis in urologic surgery. Urology. 1985; 26(1 Suppl):38–42.
3. Grabe M. Antimicrobial agents in transurethral prostatic resection. J Urol. 1987; 138:245–52.
Article
4. Helmholz HF Sr. Determination of the bacterial content of the urethra: a new method, with results of a study of 82 men. J Urol. 1950; 64:158–66.
5. Brehmer B, Madsen PO. Route and prophylaxis of ascending bladder infection in male patients with indwelling catheters. J Urol. 1972; 108:719–21.
Article
6. Grabe M, Hellsten S. Longterm followup after transurethral prostatic resection with or without a short peri-operative antibiotic course. Br J Urol. 1985; 57:444–9.
Article
7. Cafferkey MT, Falkiner FR, Gillespie WA, Murphy DM. Antibiotics for the prevention of septicaemia in urology. J Antimicrob Chemother. 1982; 9:471–7.
Article
8. Shah PJ, Williams G, Chaudary M. Short-term antibiotic prophylaxis and prostatectomy. Br J Urol. 1981; 53:339–43.
Article
9. Berry A, Barratt A. Prophylactic antibiotic use in transurethral prostatic resection: a metaanalysis. J Urol. 2002; 167:571–7.
10. Qiang W, Jianchen W, MacDonald R, Monga M, Wilt TJ. Antibiotic prophylaxis for transurethral prostatic resection in men with preoperative urine containing less than 100,000 bacteria per ml: a systematic review. J Urol. 2005; 173:1175–81.
Article
11. Naber KG, Bergman B, Bishop MC, Bjerklund-Johansen TE, Botto H, Lobel B, et al. EAU guidelines for the management of urinary and male genital tract infections. urinary tract infection (UTI) working group of the health care office (HCO) of the European association of urology (EAU). Eur Urol. 2001; 40:576–88.
12. Wagenlehner FM, Wagenlehner C, Schinzel S, Naber KG. Working Group “Urological Infections” of German Society of Urology. Prospective, randomized, multicentric, open, comparative study on the efficacy of a prophylactic single dose of 500 mg levofloxacin versus 1920 mg trimethoprim/sulfametho-xazole versus a control group in patients undergoing TUR of the prostate. Eur Urol. 2005; 47:549–56.
13. Vivien A, Lazard T, Rauss A, Laisne MJ, Bonnet F. Infection after transurethral resection of the prostate: variation among centers and correlation with a long-lasting surgical procedure. Association pour la Recherche en Anesthésie-Réanimation. Eur Urol. 1998; 33:365–9.
14. Colau A, Lucet JC, Rufat P, Botto H, Benoit G, Jardin A. Incidence and risk factors of bacteriuria after transurethral resection of the prostate. Eur Urol. 2001; 39:272–6.
Article
15. Girou E, Rioux C, Brun-Buisson C, Lobel B. Infection Committee of the French Association of Urology. The postoperative bacteriuria score: a new way to predict nosocomial infection after prostate surgery. Infect Control Hosp Epidemiol. 2006; 27:847–54.
Article
16. Huang X, Shi HB, Wang XH, Zhang XJ, Chen B, Men XW, et al. Bacteriuria after bipolar transurethral resection of the prostate: risk factors and correlation with leukocyturia. Urology. 2011; 77:1183–7.
Article
17. El Basri A, Petrolekas A, Cariou G, Doublet JD, Hoznek A, Bruyere F. Clinical significance of routine urinary bacterial culture after transurethral surgery: results of a prospective multicenter study. Urology. 2012; 79:564–9.
Article
18. Raz R, Almog D, Elhanan G, Shental J. The use of ceftriaxone in the prevention of urinary tract infection in patients undergoing transurethral resection of the prostate (TUR-P). Infection. 1994; 22:347–9.
Article
19. Viitanen J, Talja M, Jussila E, Nurmi M, Permi J, Puolakka VM, et al. Randomized controlled study of chemoprophylaxis in transurethral prostatectomy. J Urol. 1993; 150:1715–7.
Article
20. Ambiru S, Kato A, Kimura F, Shimizu H, Yoshidome H, Otsuka M, et al. Poor postoperative blood glucose control increases surgical site infections after surgery for hepato-biliary-pancreatic cancer: a prospective study in a high-volume institute in Japan. J Hosp Infect. 2008; 68:230–3.
Article
21. Dronge AS, Perkal MF, Kancir S, Concato J, Aslan M, Rosenthal RA. Longterm glycemic control and postoperative infectious complications. Arch Surg. 2006; 141:375–80.
Article
22. Shilling AM, Raphael J. Diabetes, hyperglycemia, and infections. Best Pract Res Clin Anaesthesiol. 2008; 22:519–35.
Article
Full Text Links
  • KJUTII
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr