Lack of morbidity from urodynamic studies in children with asymptomatic bacteriuria

Objectives. Patients on clean intermittent catheterization (CIC) have a hig h rate of asymptomatic bacteriuria. Although prophylactic antibiotics for r outine surgical procedures in patients with bacteriuria is common practice, the role of prophylaxis for invasive diagnostic procedures remains unclear . The aim of this study was to investigate the morbidity associated with ur odynamic evaluation in patients with asymptomatic bacteriuria. Methods. Routine urodynamic evaluation was performed in 69 pediatric patien ts (mean age 10 years). Ninety-six percent had a neurogenic bladder, and mo st were on CIC. Routine urine cultures were obtained at the time of the cys tometrogram. Forty-six patients had positive urine cultures, and 23 patient s with sterile urine served as a comparison. Patients were evaluated subjec tively for symptoms of a urinary tract infection (UTI) within 1 week of the procedure. The results of the cystometrograms were compared between the pa tients with and without bacteriuria. Results. No patient developed symptomatic UTI after the urodynamic studies. Overall, 65% of the patients with and 52% of the patients without bacteriu ria had adequate capacity and compliance, and there was no difference in th e urodynamic findings between the patients with and without bacteriuria (P = 0.4). Conclusions. Urodynamic studies were performed safely in the presence of as ymptomatic bacteriuria in the present study. Therefore, routine use of urin e cultures or prophylactic antibiotics before urodynamic studies in pediatr ic patients with a neurogenic bladder does not appear to be indicated. (C) 1999, Elsevier Science Inc.