Comparison of the risk of postoperative infection between transurethral vaporesection and transurethral resection of the prostate

Lasers Surg Med. 2014 Jul;46(5):405-11. doi: 10.1002/lsm.22240. Epub 2014 Mar 24.

Abstract

Background and objective: We observed in our department at 3 months two episodes of bacteremia postoperatively to photoselective vaporization of the prostate (PVP). We decided to compare the frequency of postoperative urinary tract infections (POUTIs) in patients with preoperative bacterial colonization of urine between PVP and transurethral resection of the prostate (TURP).

Materials and methods: From January 2010 to December 2011, we studied patients who underwent PVP or TURP for benign prostatic obstruction in our department. Preoperative urine culture (UC) was carried out for all patients and we included those with preoperative bacterial colonization of the urinary tract. Patients were treated preoperatively with an appropriate antibiotic treatment and/or inductive prophylactic antibiotics. Patients were diagnosed with POUTI if they had clinical signs of infections (e.g., fever) and a positive UC during the month after surgery.

Results: Patients were treated by PVP in 49 cases and TURP in 62 cases. A preoperative indwelling urinary catheter was inserted in 80% of the patients. During the postoperative period, eight episodes of fever were identified in the PVP group (16%), five (8%) in the TURP group (P = 0.18). We then studied the subgroup of patients with multiple bacteria strains present in the preoperative UC and identified significant differences. The risk of POUTI was significantly higher in patients treated by PVP than in those treated by TURP (P = 0.018).

Conclusions: We found significant differences between subgroups of patients with positive preoperative cultures (containing various bacterial strains). The risk of POUTI was significantly higher in patients treated by PVP.

Keywords: bacterial colonization; photoselective vaporization of the prostate; transurethral resection of the prostate; urinary tract infections.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bacteriuria / complications
  • Humans
  • Incidence
  • Lasers, Solid-State / therapeutic use*
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology*
  • Preoperative Period
  • Prostatectomy / methods*
  • Prostatic Hyperplasia / surgery*
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Transurethral Resection of Prostate
  • Treatment Outcome
  • Urinary Tract Infections / epidemiology
  • Urinary Tract Infections / etiology*