THE SOURCE OF ORGANISMS IN THE POSTPROSTATECTOMY BACTERIURIA OF PATIENTS WITH PREOPERATIVE STERILE URINE

Ninety patients undergoing prostatectomy for benign prostatic hyperpla sia (BPH) with sterile urine pre-operatively were prospectively studie d for post-prostatectomy bacteriuria; 26 of 90 patients (29%) develope d bacteriuria (18 of 64 after transurethral resection (TUR) and 8 of 2 6 after open prostatectomy), of whom 15 had pre-operative indwelling u rethral catheters. The correlation of bacteriuria with several factors was studied, namely the presence of a histological inflammatory react ion within the prostatic adenoma, prostatic tissue culture, intra-oper ative outgoing irrigation fluid culture, intra-operative blood culture and post-operative external meatal swab culture. The only significant correlation was between bacteriuria and meatal cultures. It was concl uded that post-prostatectomy bacteriuria is probably caused by post-op erative ascending infection along urethral catheters. There was not en ough evidence to ascribe bacteriuria to pre-existing septic foci withi n the adenoma. Intra-operative contamination and infection from distan t foci were also unlikely causes.