URINARY-TRACT INFECTIONS FOLLOWING LASER PROSTATECTOMY - IS THERE A NEED FOR ANTIBIOTIC-PROPHYLAXIS

Objective To evaluate the incidence of urinary tract infections (UTIs) after transurethral laser therapy of the prostate and the need for pe ri-operative antibiotics. Patients and methods One-hundred and sixteen patients (mean age 65 years, range 51-85) with benign prostatic enlar gement (BPE) were treated with a Nd:YAG laser, using either the TULIP device, the Urolase fibre or the Ultraline fibre. The incidence of voi ding complaints, UTIs and the need for catheterization after treatment were assessed. The first 43 patients (Group I) received no antibiotic s perioperatively and the next 73 patients (Group II) received co-trim oxazole for 5 days. Results The patients treated using the TULIP devic e had more urinary complaints after treatment than those treated using the Ultraline and Urolase fibres. In Group I, 48% of the patients dev eloped a UTI and in Group II the incidence of UTIs decreased to 30% af ter treatment. The incidence of UTIs was unrelated to the procedure pe rformed, Although not statistically significant, peri-operative antibi otics tended to reduce the incidence of UTIs. Prolonged catheterizatio n was correlated with the incidence of UTI. In Group I, patients who w ere treated using the Ultraline procedure had their catheter removed a fter a mean of 24 days, compared with 21 days for those treated with t he Urolase and 19 days with the TULIP device. In Group II, the patient s needed catheterization for a mean of 17 days following Ultraline tre atment and 16 days following the Urolase procedure. Conclusions Antibi otic prophylaxis tended to decrease the incidence of post-treatment UT Is. However, there was no clear association between the presentation a nd duration of complaints and the presence of UTIs.