The use of intermittent chlorhexidine bladder irrigation in the prevention of post-prostatectomy infective complications.

The efficacy of peri-operative intermittent bladder irrigation with 0.05% chlorhexidine gluconate solution in the prevention of post-prostatectomy infective complications was assessed in men with pre-operative indwelling urinary catheters. Thirty-two consecutive patients undergoing transvesical prostatectomy were randomly allocated to the test group (chlorhexidine irrigation) and control group (saline irrigation). Pre-operatively, intermittent chlorhexidine bladder irrigation achieved sterile urine in only 3 of 13 patients, in the rest bacteriuria persisted. However, the irrigation was able to reduce significantly (P < 0.05) the incidence of intra-operative bacteraemia and severe wound infection. Furthermore, septicaemia was absent and post-operative urinary catheter requirements and hospital stay were shortened. Histology of bladder mucosal biopsies revealed that 0.05% chlorhexidine used on intermittent basis caused no injuries.