Effect of Preoperative Bacteriuria and Pyuria on Intravesical Recurrence in Patients with Upper Tract Urothelial Carcinoma Undergoing Radical Nephroureterectomy

In Vivo. 2017 Nov-Dec;31(6):1215-1220. doi: 10.21873/invivo.11193.

Abstract

Background/aim: We investigated the effect of bacteriuria and pyuria on intravesical recurrence (IVR) in patients with upper tract urothelial carcinoma (UTUC) undergoing radical nephroureterectomy (RNU).

Patients and methods: Preoperative bacteriuria and pyuria were defined as urine containing ≥5 bacteria/high-power field (HPF) and >5 white blood cells/HPF, respectively. Their associations with IVR were evaluated in 97 patients with UTUC undergoing RNU.

Results: Preoperative bacteriuria [n=15 (15%)] was significantly associated with preoperative pyuria [n=42 (43%), p<0.001]. During follow-up (median of 19 months), 45 (46%) patients developed IVR (median IVR-free survival=38 months). On multivariate analysis, preoperative bacteriuria was an independent predictor for reduced risk of IVR (hazard ratio=0.23, p=0.010). The 2-year IVR-free survival of patients with preoperative bacteriuria and pyuria was significantly longer than that of patients without preoperative bacteriuria (83% vs. 54%, p=0.028) and pyuria (69% vs. 50%, p=0.024), respectively.

Conclusion: Bacteriuria and pyuria may reduce the risk of IVR in patients with UTUC undergoing RNU.

Keywords: Bacteriuria; intravesical recurrence; pyuria; radical nephroureterectomy; upper tract urothelial carcinoma.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bacteriuria / complications
  • Bacteriuria / microbiology
  • Bacteriuria / pathology*
  • Carcinoma, Transitional Cell / complications
  • Carcinoma, Transitional Cell / microbiology
  • Carcinoma, Transitional Cell / pathology
  • Carcinoma, Transitional Cell / surgery*
  • Disease-Free Survival
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Nephroureterectomy
  • Pyuria / complications
  • Pyuria / pathology*
  • Risk Factors
  • Urothelium / microbiology
  • Urothelium / pathology
  • Urothelium / surgery*