Incidence of Bacteriuria after Urodynamic Study with or without Antibiotic Prophylaxis in Women with Urinary Incontinence

Abstract

The presence of bacteria in urine is called bacteriuria, which may be symptomatic or asymptomatic. The manipulation of the urinary tract during urodynamic study (UDS), which is an invasive procedure, can result in urinary tract infection (UTI). Studies on the use of prophylactic antibiotics for UDSs are contradictory. Some investigators concluded that they were valuable and others did not. The objective of this study is to evaluate the efficacy of antibiotic prophylaxis before UDS. This is a placebo-control randomized double-blind study. Two-hundred and seventeen women affected by urinary incontinence were eligible for this study. All patients had presented negative urine culture previous to the UDS. They were randomized in four groups: group A received placebo, group B received 500 mg of levofloxacin, group C received 80 mg trimethoprim and 400 mg sulfamethoxazole and group D received 100 mg of nitrofurantoin. A urine culture was performed 14 days after the UDS. We observed asymptomatic bacteriuria after the UDS in five patients in group A, one in group B, one in group C and one in group D. Only one patient on group A had symptomatic bacteriuria. We didn't observe statistical difference between the groups. When we recategorized the patients in two groups, the incidence of bacteriuria was significantly higher in the placebo group compared with the antibiotic group. The conclusion is that antibiotic prophylaxis before the UDS did not reduce the incidence of UTI in women within the target population.

Antibiotic prophylaxis for urodynamic testing in women: a systematic review

“…1 PRISMA diagram: Flow of literature through the search and appraisal process trials were excluded from the review, one because the author did not respond to the request for female-specific data and the other because the author replied to the request for femalespecific data, but data provided were incongruent with published results. Three randomized controlled trials involving 325 patients in total were included in this review [14][15][16]. An overview of these studies can be found in Table 1.…”

Should We Always Use Antibiotics after Urodynamic Studies in High-Risk Patients?

“…УДД також може допомогти в кращому розумінні дисфункцій у пацієнтів із неврологічними розладами, а також у розумінні змін функцій нижніх сечовивідних шляхів у пацієнтів з онкологічними захворюваннями гінекологічних органів малого таза до та після радикального лікування [3,4]. УДД -це інвазивна процедура, яка передбачає катетеризацію; тому після проведення УДД можуть спостерігатися інфекції сечовивідних шляхів (ІСШ) або бактеріурія, причому частота бактеріурії становить від 1,5% до 30% [5].…”

“…Досі немає єдиної думки щодо того, чи потрібна антибактеріальна профілактика пацієнтам, які пройшли УДД. У рандомізованому дослідженні, проведеному за участю 270 пацієнтів, опублікованому E. Hirakauva та співавт., антибактеріальна профілактика перед проведенням УДД не знижувала рівень захворюваності на ІСШ у жінок [5]. Раніше G. Cundiff та співавт.…”

Should We Always Use Antibiotics after Urodynamic Studies in High-Risk Patients?

“…UDS can also help in the better understanding of dysfunctions in patients with neurologic disorders, and in comprehending the changes in lower urinary tract functions in patients with pelvic gynaecologic cancer before and after radical treatment [ 3 , 4 ]. UDS are an invasive procedure that involves catheterization; therefore, urinary tract infection (UTI) or bacteriuria may be observed after UDS, with an incidence of bacteriuria ranging from 1.5 to 30% [ 5 ].…”

“…There is still no consensus on whether antibiotic prophylaxis is necessary for patients undergoing UDS. In the randomized study conducted on 270 patients published by Hirakauva et al ., antibiotic prophylaxis before UDS did not reduce the incidence of UTI in women [ 5 ]. In the past, Cundiff et al .…”