Neurourology & Female Urology

Abstract

733Urological Survey CIS present increased over the years from 33% in the eighties to 52% in period from 2001 to 2003. The majority of patients had grade 3 tumors (82.5%) and/or pT2 and pT3 disease (60.8%). Roughly, half of the patients had lymphovascular invasion, one-fourth (24.9%) had lymph node metastases. Accordingly, after 5 years, half of the patients with concomitant CIS had recurrences and half of the patients with concomitant CIS had died from bladder cancer. Patients without concomitant CIS fared better than those with concomitant CIS (7-year recurrence-free survival 58.1% and 41.5%, respectively). Interestingly, the incidence of concomitant CIS was highest in patients with organ-confined disease (pTa excluded) and higher in lower-stage and higher grade disease. Involvement of the urethra was more common in CIS patients.The authors state correctly, that presence of concomitant CIS worsens the outcome significantly. In practical terms, early radical treatment should be considered if CIS is present. Aim: A prospective study was performed to determine the incidence of significant bacteriuria and to identify the risk factors for bacteriuria after urodynamic studies (UDSs) in women with urodynamic stress urinary incontinence (SUI). Methods: A total of 225 women with urodynamic SUI were evaluated. All women were negative on doublescreened urine cultures, in clean-catch midstream urine (MSU) specimens, before UDS. Another urine specimen was obtained for urinalysis and culture at 3-7 days after UDS. Urinary culture with 10(5) CFU/ml or more was regarded as significant bacteriuria. To identify the risk factors for significant bacteriuria, the clinical characteristics of all patients including age, BMI, parity, medical and operation history, degree of pelvic organ prolapse, results of urinalysis, and UDS were evaluated. Results: The prevalence of significant bacteriuria was 6.2%. The most common identified microorganism was Escherichia coli (57.1%). Univariate analysis demonstrated that a history of recurrent urinary tract infection (UTI; P = 0.002) and urological surgery or procedure (P = 0.02) were significant predictors of significant bacteriuria. On multiple logistic regression analysis the past history of recurrent UTI was the only significant independent risk factor (OR = 28.5, 95% CI = 4.309-188.488, P = 0.009). Dr. Andreas BohleConclusions: This study suggests that for most women with SUI it may be unnecessary to use preventive prophylactic antibiotics in UDS. However, our results suggest that in patients with a previous history of recurrent UTI or urologic surgery the risk for significant bacteriuria is increased and use of prophylactic antibiotics should be considered.