Department of Urology, Xiangfan Central Hospital, Xiangfan University, Xiangfan, China.
Urology. 2011 May;77(5):1183-7. doi: 10.1016/j.urology.2010.08.013. Epub 2010 Oct 25.
To analyze the risk factors of postoperative bacteriuria and the correlation with leukocyturia after bipolar transurethral resection of the prostate (TURP).
A total of 121 noncatheterized patients with sterile preoperative urine undergoing bipolar TURP for benign prostatic hyperplasia (BPH) were entered into the prospective study. All patients received antibiotic prophylaxis with ceftriaxone. Two urine specimens of each patient, one for urinalysis (urinary leukocyte count) and one for urine culture, were collected on removal of the catheter, 1 and 4 weeks after surgery. The risk factors of postoperative bacteriuria and correlation with leukocyturia were investigated.
The incidence of bacteriuria after bipolar TURP was 18.2% (22/121). Multivariate analysis documented 3 independent risk factors of postoperative bacteriuria: operating time >60 minutes (P = .014), duration of catheterization >3 days(P = .001), and disconnection of the closed urine drainage system (P <10(-3)). The mean leukocyte counts in urine were 405.3, 389.5, and 113.8/μL on removal of the catheter, 1 and 4 weeks after surgery, respectively. Of 363 urine specimens, the mean concentration of leukocytes with and without bacteriuria were 323.9 and 297.6/μL, respectively (P >.05). There was no significant correlation between bacteriuria and leukocyturia (>10 leukocytes/high power field (P >.05).
The results of our study have shown that the operating time, duration of catheterization, and disconnection of the closed urine drainage system may influence the occurrence of bacteriuria after bipolar TURP, and leukocyturia cannot reflect the possibility of postoperative bacteriuria.
分析经尿道双极前列腺切除术（TURP）后菌尿的危险因素及其与白细胞尿的相关性。
本前瞻性研究纳入了 121 例无导尿管的术前无菌性尿患者，这些患者均因良性前列腺增生（BPH）接受了经尿道双极 TURP 治疗。所有患者均接受头孢曲松预防性抗生素治疗。在拔除导尿管时、术后 1 周和 4 周时，采集每位患者的两份尿液标本，一份用于尿液分析（尿白细胞计数），另一份用于尿液培养。调查了术后菌尿的危险因素及其与白细胞尿的相关性。
经尿道双极 TURP 术后菌尿的发生率为 18.2%（22/121）。多变量分析记录了术后菌尿的 3 个独立危险因素：手术时间>60 分钟（P =.014）、导尿管留置时间>3 天（P =.001）和封闭尿液引流系统断开（P <10(-3)）。拔除导尿管时、术后 1 周和 4 周时的平均白细胞计数分别为 405.3、389.5 和 113.8/μL。在 363 份尿液标本中，有菌尿和无菌尿的白细胞平均浓度分别为 323.9 和 297.6/μL（P >.05）。菌尿和白细胞尿之间无显著相关性（>10 个白细胞/高倍视野）（P >.05）。
我们的研究结果表明，手术时间、导尿管留置时间和封闭尿液引流系统断开可能会影响经尿道双极 TURP 术后菌尿的发生，而白细胞尿不能反映术后菌尿的可能性。
