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Mulitcenter study on antibiotic prophylaxis, infectious complications and risk assessment in TUR-P
INTRODUCTION: Transurethral resection of the prostate is one of the most frequent urological procedures. Urinary tract infections represent major sequelae, but data about antibiotic prophylaxis in TUR-P are controversial and outdated. MATERIAL AND METHODS: We conducted a retrospective multicentre st...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Polish Urological Association
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5407338/ https://www.ncbi.nlm.nih.gov/pubmed/28461999 http://dx.doi.org/10.5173/ceju.2017.941 |
Sumario: | INTRODUCTION: Transurethral resection of the prostate is one of the most frequent urological procedures. Urinary tract infections represent major sequelae, but data about antibiotic prophylaxis in TUR-P are controversial and outdated. MATERIAL AND METHODS: We conducted a retrospective multicentre study of TUR-P in ten German hospitals. Primary endpoints were epidemiological and outcome data of TUR-P. Secondary endpoints were the identification of factors associated with febrile UTIs and sepsis after TUR-P. RESULTS: We included 444 patients with a median age of 71.0 years. Nearly every patient (93.5%) received some kind of antibiotic prophylaxis. Complication rates were 4.9% for febrile UTIs and 2.3% sepsis. Significant risk factors associated with febrile UTIs were pre-existing risk factors for UTIs (p = 0.035) and a duration of catheterization of more than three days (p <0.0001). Significant risk factors for sepsis were duration of surgery of more than 60 minutes (p = 0.030) and again a duration of catheterization of more than three days (p <0.0001). Interestingly, 50.8% of the cases had evidence of chronic prostatitis in their histological specimen. This evidence of chronic prostatitis was significantly associated with febrile UTIs (p = 0.019) and sepsis (p = 0.018). CONCLUSIONS: Duration of catheterization is one of the major risk factors for infectious complications after TUR-P. Antibiotic prophylaxis in TUR-P needs prospective investigation. These future studies should also address chronic prostatitis a priori. |
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