SUFU 2017: Best Practice Policy Statement on Urodynamic Antibiotic Prophylaxis in the Non-Index Patient

Dr. Anne P. Cameron of the University of Michigan presented the SUFU Best Practice Policy Statement on Urodynamic Antibiotic Prophylaxis in the Non-Index Patient. She outlined the guideline statements and the evidence they contain emphasizing that many patients who undergo urodynamics have risk factors for urinary tract infections (UTIs) and/or are vulnerable to significant morbidity if a UTI was to occur.

The full guideline will be published in the near future in the journal Neurourology and Urodynamics. To  summarize, however, the following patients would be included in statements that recommend prophylaxis:  those with neurogenic lower urinary tract dysfunction, elevated postvoid residual, advanced age, asymptomatic bacteriuria, immunosuppression, chronic catheters, and/or total joint replacement within 2 years or with risk factors.
Diabetes, recent hospitalization, menopausal status, obesity, a history of recurrent UTIs, prior urologic surgery, and cardiac valvular disease did not meet the panel’s criteria for suggesting antibiotic prophylaxis.

Dr. Anne P. Cameron presented the initial data on 510 women enrolled at the six Lower Urinary Tract Dysfunction Research Network sites. Using patient-reported outcomes data from multiple questionnaires, researchers found that there was significant overlap of the types of incontinence reported. Also, of the 425 women who reported incontinence, this symptom was much more likely to be mixed rather than purely the stress or the urgency type.  Patients of both sexes who reported incontinence also reported worse sexual function as well as constipation, diarrhea, and fecal incontinence. Among women with incontinence, mixed incontinence was associated with worse sexual function and more symptoms of pelvic organ prolapse compared with stress or urgency incontinence alone. 

Presented by: Anne P. Cameron, University of Michigan

Written by: Lindsey Cox, MD, Medical University of South Carolina

at 2017 SUFU - Society of Urodynamics, Female Pelvic Medicine, February 28 – March 2, 2017 Scottsdale, Arizona, USA