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℃). 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.
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.
The evaluation of preoperative risks is necessary for appropriate use of AMP for TURBT. We demonstrated that AMP was effective for patients who underwent TURBT, and may not always be necessary for patients with low/intermediate risk of infection. However, it should be necessary for patients with the risk factors, such as the history of pelvic radiotherapy, high age, longer preoperative hospital stay and a certain tumor size that are major risk factors for postoperative UTIs of TURBT.
Written by: Yuki Kohada, MD, Akihiro Goriki, MD, PhD, Kazuma Yukihiro, Shinya Ohara, MD and Mitsuru Kajiwara, MD, PhD, Department of Urology, Hiroshima Prefectural Hospital, Hiroshima, Japan
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