Investig Clin Urol.  2018 Jan;59(1):10-17. 10.4111/icu.2018.59.1.10.

Rate and association of lower urinary tract infection with recurrence after transurethral resection of bladder tumor

• Kim BS
• Tae BS
• Ku JH
• Kwak C
• Kim HH
• Jeong CW

• KMID: 2399259
• DOI: http://doi.org/10.4111/icu.2018.59.1.10

Abstract

PURPOSE
To evaluate the rate of pyuria and bacteriuria after transurethral resection of bladder tumor (TURBT).
MATERIALS AND METHODS
We retrospectively evaluated data obtained from 363 patients who underwent TURBT between October 2012 and December 2013 at Seoul National University Hospital. Urinalysis and urine culture were assessed at 3, 6, 12, and 24 months postoperatively. Primary endpoint was the rate of bacteriuria (≥105/mL in a midstream) and pyuria (white blood cells ≥5/high-power field).
RESULTS
We analyzed 306 patients who were eligible for the study. Pyuria was present in 23.5% of patients in the 3rd postoperative month and in 31.7% of patients in the 24th postoperative month. Bacteriuria was present in 1.3% of patients in the 3rd postoperative month and in 2.6% of patients in the 24th postoperative month. Among urothelial carcinoma patients (n=220), 24.1% showed pyuria and 1.8% showed bacteriuria at the 3rd postoperative month. We found that 31.8% showed pyuria and 3.2% showed bacteriuria at the 24th postoperative month. There was no significant difference in the rate of pyuria and bacteriuria between the intravesical treatment group and the no-treatment group. Multivariate analysis demonstrated that pyuria in the 3rd postoperative month (odd ratio [OR], 2.254; p=0.039), tumor multiplicity (OR, 3.331; p=0.001), and the absence of intravesical treatment (OR, 4.927; p=0.001) increases the risk of tumor recurrence.
CONCLUSIONS
A significant proportion of patients showed pyuria after TURBT during the follow-up period. Additionally, presence of pyuria in the short-term follow-up period after TURBT constitutes a risk factor for recurrence of bladder cancer.

Keyword

Pyuria; Recurrence; Urinary bladder neoplasms

MeSH Terms

Bacteriuria
Blood Cells
Follow-Up Studies
Humans
Multivariate Analysis
Pyuria
Recurrence*
Retrospective Studies
Risk Factors
Seoul
Urinalysis
Urinary Bladder Neoplasms*
Urinary Bladder*
Urinary Tract Infections*
Urinary Tract*

Figure

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  Fig. 1 The rate of pyuria over time after transurethral resection of bladder tumor (all patients, n=306; urothelial cancer, n=220). POD, postoperative day.

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  Fig. 2 The rate of bacteriuria over time after transurethral bladder tumor resection (all patients, n=306; urothelial cancer, n=220). POD, postoperative day.

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