The need for antibiotic prophylaxis before urodynamic studies

The use of antibiotic prophylaxis before urodynamic studies (US) is not recommended routinely. We investigated the factors that would enable us to predict bacteriuria that is likely to develop after US, and that make us consider the need for prophylaxis. Materials and methods: One hundred and four patients who would undergo US with a suspicion of lower urinary tract dysfunction were enrolled in the present study and followed up prospectively. The relationship between bacteriuria and several parameters, such as gender, age, body mass index, glomerular filtration rates, systemic diseases, urinary flow rates, residual urine volume, the type of process performed, and maximum cystometric capacity values, was investigated. Results: Following US, a bacteria level of 105 was detected in 7 of 104 patients (6.7%). According to the results of the Pearson's chi square test, there was a statistically significant relationship only between the presence of diabetes and bacteriuria (P = 0.013). Logistic regression analysis revealed statistically significant results indicating a direct proportion between the incidence of bacteriuria and increased post-void residual volume (P < 0.0001), with an inverse proportion between the frequency of bacteriuria and decreased bladder capacity (P = 0.021). Conclusion: Due to low rates of bacteriuria after US, the use of prophylactic antibiotics is not a routine procedure except in selected patients.

The need for antibiotic prophylaxis before urodynamic studies

The use of antibiotic prophylaxis before urodynamic studies (US) is not recommended routinely. We investigated the factors that would enable us to predict bacteriuria that is likely to develop after US, and that make us consider the need for prophylaxis. Materials and methods: One hundred and four patients who would undergo US with a suspicion of lower urinary tract dysfunction were enrolled in the present study and followed up prospectively. The relationship between bacteriuria and several parameters, such as gender, age, body mass index, glomerular filtration rates, systemic diseases, urinary flow rates, residual urine volume, the type of process performed, and maximum cystometric capacity values, was investigated. Results: Following US, a bacteria level of 105 was detected in 7 of 104 patients (6.7%). According to the results of the Pearson's chi square test, there was a statistically significant relationship only between the presence of diabetes and bacteriuria (P = 0.013). Logistic regression analysis revealed statistically significant results indicating a direct proportion between the incidence of bacteriuria and increased post-void residual volume (P < 0.0001), with an inverse proportion between the frequency of bacteriuria and decreased bladder capacity (P = 0.021). Conclusion: Due to low rates of bacteriuria after US, the use of prophylactic antibiotics is not a routine procedure except in selected patients.

___

  • Bombieri L, Dance DA, Rienhart GW, Waterfi eld A, Freeman RM. Urinary tract infection aft er urodynamic studies in women: incidence and natural history. BJU Int 1999; 83: 392-5. 2. Okorocha I, Cumming G, Gould I. Female urodynamics and lower urinary tract infection. BJU Int 2002; 89: 863-7. 3. Almallah YZ, Rennie CD, Stone J, Lancashire MJ. Urinary tract infection and patient satisfaction aft er fl exible cystoscopy and urodynamic evaluation. Urology 2000; 56: 37-9.
  • Sabanathan K, Duffi n HM, Castleden CM. Urinary tract infection aft er cystometry. Age Ageing 1985; 14: 291-5. 5. Klingler HC, Madersbacher S, Djavan B, Schatzl G, Marberger M, Schmidbauer CP. Morbidity of the evaluation of the lower urinary tract with transurethral multichannel pressure-fl ow studies. J Urol 1998; 159: 191-4. 6. Porru D, Madeddu G, Campus G, Montisci I, Scarpa RM, Usai E. Evaluation of morbidity of multi-channel pressure-fl ow studies. Neurourol Urodyn 1999; 18: 647-52.
  • Carter PG, Lewis P, Abrams P. Urodynamic morbidity and dysuria prophylaxis. Br J Urol 1991; 67: 40-1.
  • Webster GD. Basic Urodynamics Course 2007. American Urological Association Annual Meeting, Anaheim, CA, USA. 9. Warren JW. Catheter-associated urinary tract infections. Int J Antimicrob Agents 2001; 17: 299-303.
  • Sedor J, Mulholland SG. Hospital-acquired urinary tract infections associated with the indwelling catheter. Urol Clin of North Am 1999; 26: 821-8.
  • Warren J, Bakke A, Desgranchamps F, Johnson JR, Kumon H, Shah J et al. Catheter associated bacteriuria and the role of biomaterial in prevention. In: Naber KG, Pechere JC, Kumazawa J, Khoury S, Gerberding IL, Schaeff er AJ, eds. Nosocomial and health care associated infections in urology. Plymouth: Health Publications Ltd 2001; pp. 153-176.
  • Siracusano S, Knez R, Tiberio A, Alfano V, Giannantoni A, Pappagallo G. Th e usefulness of antibiotic prophylaxis in invasive urodynamics in postmenopausal female subjects. Int Urogynecol J 2008; 19: 939-42.
  • Tong AVM, Cheon WC. Urinary tract infection aft er urodynamic study in women. HKJGOM 2005; 5: 22-5.
  • Beylot M, Marion D, Noel G. Ultrasonographic determination of residual urine in diabetic subjects: relationship to neuropathy and urinary tract infection Diabetes Care 1982; 5: 501-5.
  • Tan TL, Lieu PK, Ding YY Urinary retention in hospitalised older women. Ann Acad Med Singapore 2001; 30: 588-92.
  • Sobel JD. Pathogenesis of urinary tract infection; role of host defenses. Infect Dis Clin North Am 1997; 11: 531-49.
  • Goswami R, Bal CS, Tejaswi S. Prevalence of urinary tract infection and renal scars in patients with diabetes mellitus. Diabetes Res Clin Pract 2001; 53: 181-6.
  • Bartelink ML, Hoek L, Freriks JP, Rutten GE. Infections in patients with type 2 diabetes in general practice. Diabetes Res Clin Pract 1998; 40: 15-9.
  • Yenilmez A, Kebapci N, Isikli B, Hamarat M, Donmez T. Morbidity aft er urodynamic study in diabetic patients. Acta Diabetol 2009; 49: 197-202.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: 6
  • Yayıncı: TÜBİTAK
Sayıdaki Diğer Makaleler

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Postoperatif atriyal fi brilasyon, infl amasyon ve oksidatif stress

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Ventricular functions, aortic elastic properties, and endothelial functions in patients with hypertensive response to treadmill exercise testing

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An evaluation of the undergraduate occupational health internship program at Kocaeli University's Faculty of Medicine

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Distribution of congenital heart disease in Turkey

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About cholecalciferol insufficiency

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Taurine is protective against oxidative stress during cold ischemia in the rat kidney

Bünyamin MUSLU, Hüseyin SERT, Muhammet GÖZDEMİR, Rüveyda İrem DEMİRCİOĞLU, Burhanettin USTA

The need for antibiotic prophylaxis before urodynamic studies

Fuat KIZILAY, Rashad MAMMADOV, Mehmet Ceyhun ÖZYURT, Adnan ŞİMŞİR

Treadmil egzersiz testine hipertansif yanıtı olan hastalarda ventrikül fonksiyonları, aortun elastik özellikleri ve endotel fonksiyonları

Fethi KILIÇASLAN, Bekir Sıtkı CEBECİ, Ata KIRILMAZ, Oben BAYSAN, Mehmet YOKUŞOĞLU, Rifat Eralp ULUSOY

Developing and comparing two diff erent prognostic indexes for predicting disease-free survival of nonmetastatic breast cancer patients

Mustafa Cem UZAL, İmran ÖMÜRLÜ KURT, Mevlüt TÜRE, Zehra Füsun TOKATLI, Ruşen ALAS ÇOŞAR