Aghamir Seyed Mohammad Kazem, Hamidi Morteza, Salavati Alborz, Mohammadi Abdolreza, Farahmand Hasan, Meysamie Ali Pasha, Ghorbani Behrooz
Department of Urology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Acta Med Iran. 2011;49(8):513-6.
Transurethral Ureterolithotripsy (TUL) is a frequently used procedure in urology departments. Many urologists perform TUL without antibiotic prophylaxis; however the use of chemoprophylaxis before TUL remains a controversial issue in urology. This study was carried out to assess the safety of omitting antibiotic prophylaxis prior to TUL. In a prospective randomized clinical trial from January 2005 to December 2007, 114 patients with ureteral stones were enrolled; Fifty seven had preoperative antibiotic prophylaxis administered before TUL and fifty seven patients underwent TUL without antibiotic prophylaxis. The rate of postoperative infectious complications (fever, positive blood culture, significant bactriuria), the length of hospital stay and overall stone free rate were compared between the two groups. There was no statistically significant difference between two groups in the operation time, length of hospital stay, postoperative bacteriuria, positive urine culture, postoperative fever and overall success rate of TUL. It appears that the incidence of infectious complications does not increase in patients undergoing TUL without antibiotic prophylaxis if they have negative pre-operative urine culture and antiseptic technique have been performed thorough the procedure.
经尿道输尿管碎石术（TUL）是泌尿外科常用的手术。许多泌尿外科医生在进行TUL时不使用抗生素预防；然而，TUL术前使用化学预防在泌尿外科仍是一个有争议的问题。本研究旨在评估TUL术前省略抗生素预防的安全性。在2005年1月至2007年12月的一项前瞻性随机临床试验中，纳入了114例输尿管结石患者；57例在TUL术前接受了术前抗生素预防，57例患者在未进行抗生素预防的情况下接受了TUL。比较两组术后感染并发症（发热、血培养阳性、显著菌尿）的发生率、住院时间和总体结石清除率。两组在手术时间、住院时间、术后菌尿、尿培养阳性、术后发热和TUL总体成功率方面无统计学显著差异。如果术前尿培养阴性且在整个手术过程中采用了消毒技术，那么未进行抗生素预防的TUL患者感染并发症的发生率似乎不会增加。
