Efficacy of routine screening of urine culture before transurethral prostatectomy on the improvement of the postoperative outcome: A single‐centre experience

Abstract

Aim:The aim of the present study was to reduce the complication rate and postoperative morbidity after transurethral prostatectomy by routine urine culture before surgery. Patients and Methods: Urine culture was saved 2 weeks prior to surgery for all patients undergoing transurethral prostatectomy at the United Christian Hospital from May 2013 to October 2013. The urine culture result was screened before surgery. Antibiotic treatment was given according to the bacteria-sensitivity profile if the culture was positive. Urine culture was repeated 1 h before surgery to review the efficacy of antibiotic treatment. Postoperative outcome measures included urinary tract infection (UTI) rate, postoperative fever rate, hospital stay and 30-day readmission rate. A retrospective comparison was made with patients undergoing surgery from November 2012 to April 2013. Results: A total of 247 cases were included in the study, with 97 cases (39.3 per cent) in the study group and 150 (60.7 per cent) in the control group. Overall, 8.5 per cent of patients had postoperative UTI. Episodes of postoperative fever (11.3 per cent vs 22 per cent, P = 0.032) were lower and postoperative hospital stay was shorter for the study group. The 30-day unplanned readmission rate (8 per cent vs 19.3 per cent, P = 0.017) was also significantly lower in the study group. Multivariate analysis showed that the treatment of preoperative bacteriuria was the only significant variable determining the length of hospital stay (P = 0.001). Total resection time (P = 0.017), days of postoperative bladder irrigation (P = 0.007) and the presence of postoperative fever (P = 0.035) were significant variables with a positive correlation for 30-day readmission. Conclusion: Routine reviews of urine culture and treatment of bacteriuria before transurethral prostatectomy can reduce episodes of postoperative fever, hospital stay and the 30-day unplanned readmission rate after surgery.