Department of Urology, AIIMS, New Delhi, 110029, New Delhi, India.
Department of Microbiology, AIIMS, New Delhi, 110029, New Delhi, India.
Sci Rep. 2020 Feb 27;10(1):3585. doi: 10.1038/s41598-020-60522-4.
Office cystoscopy may be associated with urinary tract infection (UTI) in up to 10-20% of patients. Current practice of surgical part preparation in males with povidone-iodine excludes distal urethra in males, leaving a possibility for resident intra-urethral flora to cause post-procedural UTI. We designed this randomized study to assess whether additional cleaning of distal urethra with povidone-iodine solution can help reduce post-procedural incidence of UTIs in this setting. Additionally, urethral swab culture was done in the entire cohort to identify the prevalent microflora in the distal male urethra and to evaluate its role in causation of post-procedural UTI. Using a specialized urethral swab culture methodology, 85% males demonstrated some bacteria and 16% showed common uro-pathogens. 28 (14.5%) cases had post-procedure culture positive UTI. The incidence of UTI in control group (22%) was significantly more than the intervention group (7%) (p value <0.007). This result strongly supports inclusion of distal urethral irrigation with povidone-iodine in males before office cystoscopy, even when pre-procedure mid-stream urine culture is sterile.
在高达 10-20%的患者中，门诊膀胱镜检查可能与尿路感染（UTI）有关。目前，男性使用聚维酮碘进行手术部位准备时，不包括男性的远端尿道，这使得尿道内常驻菌群有可能导致术后 UTI。我们设计了这项随机研究，以评估在这种情况下，用聚维酮碘溶液额外清洁远端尿道是否有助于降低术后 UTI 的发生率。此外，对整个队列进行尿道拭子培养，以确定男性远端尿道中常见的微生物群，并评估其在术后 UTI 发病机制中的作用。使用专门的尿道拭子培养方法，85%的男性显示出一些细菌，16%的男性显示出常见的尿路病原体。28 例（14.5%）术后培养阳性 UTI。对照组（22%）的 UTI 发生率明显高于干预组（7%）（p 值<0.007）。这一结果强烈支持在门诊膀胱镜检查前用聚维酮碘冲洗男性的远端尿道，即使术前中段尿培养无菌。
