Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Sex Med Rev. 2018 Jan;6(1):157-161. doi: 10.1016/j.sxmr.2017.03.007. Epub 2017 May 3.
A preoperative negative urine culture is generally advised before implantation of urologic prosthetics to prevent device infection. However, a review of the medical literature indicates sparse evidence to support this practice.
To describe outcomes for patients undergoing prosthetic implantation without preoperative urine cultures.
The cases of men undergoing artificial urinary sphincter (AUS) and/or inflatable penile prosthesis (IPP) placement at a tertiary care center from 2007 through 2015 were reviewed. Of 713 devices implanted in 681 patients (337 AUSs in 314 patients, 376 IPPs in 367), 259 cases without preoperative urine cultures were analyzed (41%). Patients received standard perioperative antibiotics.
Device infection was diagnosed clinically. Average follow-up was 15 months.
Device infection occurred in 4 of 259 patients (1.5%) with no difference noted in infection rate between device groups (AUS = 3 of 174 [2%]; IPP = 1 of 85 [1%]; P = .99); this rate appears to be consistent with the infection rate of numerous other published prosthetic series. Common skin organisms were implicated as the infectious agents in half the infected devices. Only one patient (0.4%) developed an Escherichia coli infection.
This study suggests that prosthetic urologic surgery can be safely performed without preoperative urine cultures. Kavoussi NL, Viers BR, Pagilara TL, et al. Are Urine Cultures Necessary Prior to Urologic Prosthetic Surgery? Sex Med Rev 2018;6:157-161.
一般建议在植入泌尿科假体前进行术前阴性尿液培养，以预防器械感染。然而，对医学文献的回顾表明，支持这种做法的证据很少。
描述在没有术前尿液培养的情况下接受假体植入的患者的结局。
回顾了 2007 年至 2015 年在一家三级保健中心接受人工尿道括约肌（AUS）和/或可膨胀阴茎假体（IPP）植入的男性患者的病例。在 681 例患者中（314 例患者中有 337 例 AUS，367 例患者中有 376 例 IPP），分析了 259 例无术前尿液培养的病例（41%）。患者接受了标准的围手术期抗生素治疗。
器械感染通过临床诊断。平均随访时间为 15 个月。
在 259 例患者中，有 4 例（1.5%）发生器械感染，两组器械感染率无差异（AUS 为 174 例中的 3 例[2%]；IPP 为 85 例中的 1 例[1%]；P =.99）；这一比率似乎与许多其他已发表的假体系列的感染率一致。感染器械中有一半涉及常见的皮肤病原体。只有 1 例（0.4%）患者发生大肠埃希菌感染。
本研究表明，在没有术前尿液培养的情况下，泌尿科假体手术可以安全进行。
