Souiden Lina, Tu Le Mai, Bordeleau Maxence, Laberge Geneviève, Richard Patrick O, Ismail Salima
Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, QC, Canada.
Department of Urology, CIUSSSE-CHUS, Université de Sherbrooke, Sherbrooke, QC, Canada.
World J Urol. 2025 Jun 26;43(1):398. doi: 10.1007/s00345-025-05775-2.
Complicated urinary tract infections (UTI) after transurethral resection of bladder or prostate tumor (TURBT, TURP) are one of the most frequent and significant complications. However, recommendations for pre-operative antibiotic prophylaxis and treatment of asymptomatic bacteriuria differ greatly. This study aims to determine the prevalence of complicated UTI following TURP and TURBT. The secondary objective is to identify pre and postoperative risk factors associated with complicated UTI.
A retrospective institutional cohort study was conducted by analyzing records of patients who had either a TURP or a TURBT between January 2020 and December 2021 at the Centre intégré universitaire de santé et de services sociaux de l'Estrie-Centre hospitalier universitaire de Sherbrooke (CIUSSE-CHUS). The prevalence of complicated UTI requiring hospitalization up to 30 days after surgery and associated risk factors were recorded.
Out of the 701 patients included, 579 (82.6%) were men and the median age was 72.9 years (IQR: 67-79). In total, 505 (72.0%) patients had undergone a TURBT while 196 (28.0%) had a TURP. Readmission for a complicated UTI was necessary in 16 (2.3%) patients. American Society of Anesthesiologists scores of 3 and 4 were significantly associated with a higher prevalence of post-operative complicated UTI (OR 3.39; CI 1.21-10.8; p = 0.025).
The prevalence of complicated UTI after TURBT and TURP is relatively low. However, patients with more comorbidities are at greater risk of serious post-operative infectious complications. Antibiotic regimen for patients with pre-operative asymptomatic bacteriuria should therefore be further personalized.
经尿道膀胱肿瘤切除术（TURBT）或经尿道前列腺切除术（TURP）后发生的复杂性尿路感染（UTI）是最常见且严重的并发症之一。然而，对于术前抗生素预防和无症状菌尿症的治疗建议差异很大。本研究旨在确定TURP和TURBT后复杂性UTI的患病率。次要目标是识别与复杂性UTI相关的术前和术后危险因素。
通过分析2020年1月至2021年12月在谢布鲁克大学中心医院-艾斯特里综合大学健康与社会服务中心（CIUSSE-CHUS）接受TURP或TURBT治疗的患者记录，进行一项回顾性机构队列研究。记录术后30天内需要住院治疗的复杂性UTI的患病率及相关危险因素。
纳入的701例患者中，579例（82.6%）为男性，中位年龄为72.9岁（四分位间距：67 - 79岁）。共有505例（72.0%）患者接受了TURBT，196例（28.0%）接受了TURP。16例（2.3%）患者因复杂性UTI再次入院。美国麻醉医师协会评分为3分和4分与术后复杂性UTI的较高患病率显著相关（比值比3.39；置信区间1.21 - 10.8；p = 0.025）。
TURBT和TURP后复杂性UTI的患病率相对较低。然而，合并症较多的患者术后发生严重感染并发症的风险更高。因此，对于术前无症状菌尿症患者的抗生素治疗方案应进一步个体化。
