Postoperative Incidence of Symptomatic Urinary Tract Infection (UTI) and Microbial Pattern Seen in TURP Patients with Negative Cultures Preoperatively

Abstract

Background: Transurethral Resection of the Prostate (TURP) is the gold standard for surgical treatment of benign prostate hyperplasia (BPH). One of the postoperative complications of TURP is urinary tract infection (UTI). Symptomatic UTI occur despite preoperative sterile urine, prophylactic antibiotics and a closed drainage system. We studied the incidence of such symptomatic UTI and the microbial pattern observed. Material and Methods: This was a prospective study of 220 patients who had monopolar TURP in our centre from 2015 to 2020. All patients had sterile urine before surgery. Catheters were removed three days postoperatively. Patients presenting with symptoms of UTI were subjected to urine culture and antibiotic sensitivity. The recorded variables include patient demographics, co-morbid factors; Diabetes, hypertension, presence or absence of preoperative catheterization, duration of surgery, presence of postoperative UTI, microbial patterns and antibiotic sensitivity patterns. Results: The mean age of the patient was 66.25 years. 35.5% had preoperative catheterization. 42 (19%) patients were established to have symptomatic UTI. Age ≥ 65 years, duration of surgery ≥60 mins led to higher infection rates but preoperative catheterization, diabetes and hypertension did not influence UTI rates. The commonest organism was E. Coli and the most common sensitive antibiotic was levofloxacin (quinolone). Conclusions: Symptomatic UTI post-TURP still occurs despite preoperative sterile urine and routine prophylactic antibiotics.