Incidence and risk factors of bacteriuria after transurethral resection ofthe prostate

Introduction: Postoperative bacteriuria is a frequent event after transuret hral resection of the prostate, despite the use of prophylactic antibiotics . Certain risk factors have been clearly established (preoperative urinary catheter or bacteriuria, operating time), while others remain uncertain. Materials and Methods: We conducted a prospective study in five urology cen ters, including non-catheterized patients with sterile preoperative urine u ndergoing transurethral resection of the prostate for benign prostatic hype rplasia. All received antibiotic prophylaxis with cefamandole. The incidenc e of bacteriuria and its risk factors were investigated. Results: The postoperative bacteriuria rate was 26% (26/101), with 8% on re moval of the catheter, 14% between the 7th and 10th postoperative days and 5% 1 month postoperatively. Factors associated with bacteriuria on univaria te analysis were: operating time, disconnection of the closed urine drainag e system and postoperative catheterization greater than or equal to3 days. Two variables were associated on multivariate analysis (logistic regression ): operating time >52 min (odds ratio 9.0, 95% confidence interval 2.1-39.0 ) and disconnection of the closed urine drainage system (odds ratio 26.3, 9 5% confidence interval 6.1; 6.1-113). Conclusions: The postoperative bacteriuria rate after transurethral resecti on of the prostate was high in this study, raising the question of the choi ce and/or duration of prophylactic antibiotics. Prevention of postoperative bacteriuria must be based on careful hemostasis, prevention of postoperati ve catheter disconnections, and limitation of the duration of postoperative catheterization. Copyright (C) 2001 S. Karger AG, Basel.