Clinical significance of routine urinary bacterial culture after transurethral surgery: results of a prospective multicenter study

Urology. 2012 Mar;79(3):564-9. doi: 10.1016/j.urology.2011.11.018.

Abstract

Objectives: The objective of this study was to evaluate the prevalence and the clinical outcomes of asymptomatic postoperative bacteriuria after transurethral operations, along with the need for postoperative urinalysis.

Methods: A prospective study of 456 patients who underwent transurethral resection of the prostate (TURP) or transurethral resection of the bladder (TURB) at 2 urological centers in France, between January 2008 and March 2009. All patients had urine cultures preoperatively, on the day of catheter removal, and at 1 month postoperatively. Only patients with symptoms suggesting a urinary tract infection were treated. Univariate logistic regression and multiple logistic regression were used to estimate the odds ratios and P values.

Results: TURP was performed in 217 patients, and TURB was performed in 239 patients. A total of 35 patients (7.6%) had positive postoperative urine cultures. Only 9 patients (1.9%) were treated. Patient age and postoperative catheterization duration were identified as risk factors for postoperative bacteriuria (OR = 1; 95% CI = 1.0-1.1; P = .03 and OR = 3.6; 95% CI = 2.3-5.7; P = .0001, respectively), and preoperative bacteriuria was not risk factor for postoperative bacteriuria (OR = 0.9; 95% CI = 0.3-1.4; P = .8). A total of 45 patients had a positive urinalysis at 1 month, and 29 presented an infectious complication during follow-up. A positive postoperative urinalysis was not a risk factor either for a positive urinalysis at 1 month or for an infectious complication during follow-up (OR = 3.2; 95% CI = 0.4-22.4, P = .2 and OR = 1.4; 95% CI = 0.4-4.9, P = .5, respectively).

Conclusions: Based on our study findings, postoperative bacteriuria is not a risk factor for infectious postoperative complications. Therefore, routine postoperative urinalysis should be advocated only in symptomatic patients.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Asymptomatic Infections
  • Bacteriuria / epidemiology*
  • Bacteriuria / pathology
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Postoperative Complications / epidemiology
  • Prevalence
  • Prospective Studies
  • Risk Factors
  • Transurethral Resection of Prostate* / adverse effects
  • Urinalysis / statistics & numerical data
  • Urinary Bladder / surgery*