Clinical Significance of Routine Urinary Bacterial Culture After Transurethral Surgery: Results of a Prospective Multicenter Study

• Published in: Urology (Ridgewood, N.J.) N.J.), 2012-03, Vol.79 (3), p.564-569
• Main Authors: El Basri, Adil, Petrolekas, Andreas, Cariou, Gerard, Doublet, Jean Dominique, Hoznek, Andras, Bruyere, Franck
• Format: Article
• Language: English
• Subjects: Aged; Asymptomatic Infections; Bacteriuria - epidemiology; Bacteriuria - pathology; Biological and medical sciences; Female; Humans; Logistic Models; Male; Medical sciences; Middle Aged; Multivariate Analysis; Nephrology. Urinary tract diseases; Postoperative Complications - epidemiology; Prevalence; Prospective Studies; Risk Factors; Transurethral Resection of Prostate - adverse effects; Urinalysis - utilization; Urinary Bladder - surgery; Urology
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/j.urology.2011.11.018

Objectives The objective of this study was to evaluate the prevalence and the clinical outcomes of asymptomatic postoperative bacteriuria after transurethral operations, along with the need for postoperative urinalysis. Methods A prospective study of 456 patients who underwent transurethral resection of the prostate (TURP) or transurethral resection of the bladder (TURB) at 2 urological centers in France, between January 2008 and March 2009. All patients had urine cultures preoperatively, on the day of catheter removal, and at 1 month postoperatively. Only patients with symptoms suggesting a urinary tract infection were treated. Univariate logistic regression and multiple logistic regression were used to estimate the odds ratios and P values. Results TURP was performed in 217 patients, and TURB was performed in 239 patients. A total of 35 patients (7.6%) had positive postoperative urine cultures. Only 9 patients (1.9%) were treated. Patient age and postoperative catheterization duration were identified as risk factors for postoperative bacteriuria (OR = 1; 95% CI = 1.0-1.1; P = .03 and OR = 3.6; 95% CI = 2.3-5.7; P = .0001, respectively), and preoperative bacteriuria was not risk factor for postoperative bacteriuria (OR = 0.9; 95% CI = 0.3-1.4; P = .8). A total of 45 patients had a positive urinalysis at 1 month, and 29 presented an infectious complication during follow-up. A positive postoperative urinalysis was not a risk factor either for a positive urinalysis at 1 month or for an infectious complication during follow-up (OR = 3.2; 95% CI = 0.4-22.4, P = .2 and OR = 1.4; 95% CI = 0.4-4.9, P = .5, respectively). Conclusions Based on our study findings, postoperative bacteriuria is not a risk factor for infectious postoperative complications. Therefore, routine postoperative urinalysis should be advocated only in symptomatic patients.