Neuro-Urology, Swiss Paraplegic Research, Nottwil, Switzerland.
Neuro-Urology, Swiss Paraplegic Centre, Nottwil, Switzerland.
Neurourol Urodyn. 2024 Sep;43(7):1609-1616. doi: 10.1002/nau.25516. Epub 2024 May 27.
Video-urodynamic studies (VUDS) are the recommended standard of diagnostic care to objectively assess neurogenic lower urinary tract dysfunction (NLUTD) in individuals with spinal cord injury/disease (SCI/D). This examination requires the insertion of a catheter into the bladder, which increases the risk of a urinary tract infection (UTI). Data on symptomatic UTIs after VUDS are limited.
A single-center, observational study was conducted to evaluate the incidence of patient-reported UTI signs and symptoms 7 days after VUDS. No peri-interventional antibiotics were administered. The effect of sex, age, SCI/D duration, bladder evacuation method, bacteriuria, UTI prophylaxis, UTI history, or unfavorable VUDS results on the occurrence of patient-reported UTI signs or symptoms after VUDS was examined using binary logistic regression analysis.
A total of 140 individuals with a mean age of 59.1 ± 14.0 years and a median SCI/D duration of 15.0 years (6/29 years) were evaluated. Seven days (mean 7 ± 1 days) after VUDS, 42 (30%) individuals reported at least one UTI sign or symptom. In the majority, signs and symptoms resolved without the need for antibiotic treatment, which was required in seven participants (5%). Male sex significantly (p = 0.04) increased the odds (odds ratio 3.74) of experiencing UTI signs and symptoms after VUDS.
In individuals with NLUTD, 30% experienced UTI signs and symptoms 1 week after VUDS. However, these signs and symptoms were transient and only 5% required antibiotic treatment. Thus, antibiotic prophylaxis does not seem necessary in all individuals with SCI/D undergoing VUDS.
视频尿动力学研究(VUDS)是评估脊髓损伤/疾病(SCI/D)患者神经源性下尿路功能障碍(NLUTD)的推荐标准诊断方法。该检查需要将导管插入膀胱,这会增加尿路感染(UTI)的风险。关于 VUDS 后症状性 UTI 的数据有限。
进行了一项单中心观察性研究,以评估 VUDS 后 7 天患者报告的 UTI 体征和症状的发生率。没有给予围手术期抗生素。使用二元逻辑回归分析检查性别、年龄、SCI/D 持续时间、膀胱排空方法、菌尿、UTI 预防、UTI 病史或不利的 VUDS 结果对 VUDS 后患者报告的 UTI 体征或症状发生的影响。
共评估了 140 名平均年龄为 59.1±14.0 岁、SCI/D 持续时间中位数为 15.0 年(6/29 年)的个体。VUDS 后 7 天(平均 7±1 天),42(30%)名个体报告至少有一种 UTI 体征或症状。在大多数情况下,无需抗生素治疗即可缓解这些体征和症状,有 7 名参与者(5%)需要。男性性别显著(p=0.04)增加了 VUDS 后发生 UTI 体征和症状的几率(优势比 3.74)。
在 NLUTD 患者中,30%的人在 VUDS 后 1 周出现 UTI 体征和症状。然而,这些体征和症状是短暂的,只有 5%需要抗生素治疗。因此,并非所有接受 VUDS 的 SCI/D 患者都需要预防性使用抗生素。