The risk factors of urinary tract infection after transurethral resection of bladder tumors

World J Urol. 2019 Dec;37(12):2715-2719. doi: 10.1007/s00345-019-02737-3. Epub 2019 Mar 26.

Abstract

Purpose: Few studies mention the necessity of antimicrobial prophylaxis (AMP) for transurethral resection of bladder tumor (TURBT) and the risk factors for postoperative urinary tract infections (UTIs) after TURBT. To evaluate the necessity of AMP and to detect the risk of UTIs, we examined the perioperative clinical factors.

Methods: 687 patients who underwent TURBT between 2006 and 2017 at Hiroshima Prefectural Hospital were examined retrospectively. We defined the postoperative UTIs as febrile UTIs (≥ 38 °C). The AMP for the TURBT that we used was mostly cephalosporin generation 1. The association between the perioperative clinical/pathological factors and postoperative UTIs was assessed by logistic regression retrospectively.

Results: 21 patients (3.1%) suffered from postoperative UTIs, and almost all of them were successfully treated with the immediate administration of antibiotics. Univariate analysis showed that past pelvic radiotherapy (p = 0.024, odds ratio (OR) 6.00), tumor size (≥ 2cm) (p = 0.008, OR 3.38), age (≥ 75 years) (p = 0.036, OR 2.65), preoperative hospital stay (≥ 5 days) (p = 0.017, OR 3.76), asymptomatic pyuria (p = 0.038, OR 2.54) and bacteriuria (p = 0.044, OR 2.97) were all associated with postoperative UTIs.

Conclusions: We demonstrated that AMP was effective for patients who underwent TURBT, and history of pelvic radiotherapy, high age, preoperative hospital stay and a certain tumor size were the risk factors as well as pyuria and bacteriuria of postoperative UTIs.

Keywords: Antimicrobial prophylaxis; Surgical site infection; Transurethral resection of bladder tumors; Urinary tract infections.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antibiotic Prophylaxis*
  • Cystectomy* / methods
  • Female
  • Humans
  • Male
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / prevention & control*
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Urethra
  • Urinary Bladder Neoplasms / surgery*
  • Urinary Tract Infections / epidemiology*
  • Urinary Tract Infections / prevention & control*