Antibiotic Prophylaxis and Secondary Haemorrhage Following Transurethral Resection of the Prostate: a Prospective Trial

Harvey, Martyn; Leese, T; Lloyd, D. M.; Osborn, D. E.

doi:10.1111/j.1464-410x.1986.tb09102.x

Cited by 11 publications

(12 citation statements)

References 10 publications

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“…In the study by Harvey et al ., they reported an overall risk of secondary hemorrhage in their series being 25%. [11] Ehrlich et al . observed the rate of secondary hemorrhage to be 10.8% in their cohort.…”

Section: Discussionmentioning

confidence: 99%

“…attempted to use a 2-week course of co-trimoxazole to decrease the risk of secondary hemorrhage without success. [11] In their randomized controlled trial, while there was a significant correlation between the incidence of secondary hemorrhage and urine infection at catheter removal, no difference in the incidence of bleeding was found in the two treatment arms. No more studies on urinary tract infection and secondary hemorrhage after TURP had been published ever since.…”

Section: Discussionmentioning

confidence: 99%

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Secondary hemorrhage after bipolar transurethral resection and vaporization of prostate

et al. 2016

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Introduction:We evaluated the factors associated with secondary hemorrhage after bipolar transurethral resection of prostate (TURP) and vaporization of prostate.Materials and Methods:The perioperative data of patients undergoing endoscopic surgery for benign prostatic hyperplasia (BPH) were prospectively collected. Procedures involved included bipolar TURP, bipolar vaporization of prostate, and hybrid bipolar TURP/vaporization of prostate. Secondary hemorrhage was defined as bleeding between 48 h and 30 days postsurgery requiring hospital attendance with or without admission. Risk factors for secondary hemorrhage were analyzed.Results:From 2010 to 2013, 316 patients underwent bipolar surgery for BPH. Bipolar TURP accounted for 48.1% of the procedures, bipolar vaporization accounted for 20.3% of the procedures, and the rest were hybrid TURP/vaporization of prostate. Among this cohort of patients, fifty patients had secondary hemorrhage with hospital attendance. Consumption of platelet aggregation inhibitors (PAIs) was found to be associated with secondary hemorrhage (P < 0.0005). Age, prostate volume, operation type, the use of 5-alpha reductase inhibitors, and being with a urethral catheter before operation were not found to be statistically significant risk factors for secondary hemorrhage.Conclusions:Secondary hemorrhage after bipolar surgery for BPH is a common event. Consumption of PAI is a risk factor for such complication.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Secondary hemorrhage after bipolar transurethral resection and vaporization of prostate

et al. 2016

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“…6,[18][19][20][21][22][23][24][25] This is further supported by a RCT demonstrating equivalent outcomes with the use of levofloxacin versus TMP-SMX as antibiotic prophylaxis for TURP. 2 As such, the wide variety of antibiotic regimens used by urologists at our institution is understandable as no single agent stands out as superior with respect to efficacy (Fig.…”

Section: Discussionmentioning

confidence: 52%

“…4 Clinical efficacy was shown for antibiotic classes including fluoroquionolones, third generation cephalosporins, aminoglycosides and trimethroprim-sulfamethoxazole (TMP-SMX). [18][19][20][21][22][23][24][25] Based on the available evidence, the 2008 American Urology Association (AUA) Best Practice Statements (BPS) on Urologic Surgery Antimicrobial Prophylaxis recommends use of prophylactic antibiotics for all patients undergoing TURP. 1 The recommended first-line agents are fluoroquinolones or TMP-SMX, with alternatives including aminoglycosides alone or with ampicillin, cephalosporins or amoxicillin/clavulanate <24 hours prior to TURP.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Antibiotic Prophylaxis Prescribing Patterns for TURP: A Need for Canadian Guidelines?

Lawson

Rudzinski

Vicas

et al. 2013

CUAJ

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Background: While antibiotic prophylaxis is recommended to all patients undergoing transurethral resection of prostate (TURP), little data exist regarding prescribing patterns of urologists prior to this procedure. Here, we sought to determine real-world antibiotic prophylaxis prescribing patterns at a high volume Canadian institution and determine compliance rates to recommendations put forth by the American Urological Association's (AUA) Best Practice Statement (BPS) on antimicrobial prophylaxis. Methods: A retrospective chart review of 488 patients undergoing TURP was conducted. Electronic medical records were reviewed to determine antibiotics prescribed 3 hours preoperatively and 24 hours postoperatively. For patients without a catheter, compliance was defined as those receiving an antibiotic prior to TURP. In patients with an indwelling catheter, compliance was defined as those receiving antibiotics from two different classes prior to surgery. Results: Overall, a total of 30 antibiotic regimens were utilized. The most common single antibiotic regimens prescribed were ciprofloxacin (32%), cefazolin (25%) and gentamicin (3%). In those patients with indwelling Foley catheters prior to TURP, a significant increase in gentamicin, as well as combination antibiotic regimens, was noted. The compliance rate with the AUA BPS in patients without a preoperative catheter was 81%, while the compliance rate for patients with an indwelling catheter prior to TURP was 37%. Interpretation: Collectively, our results demonstrate that prescribing patterns vary significantly prior to TURP, with compliance to AUA BPS being lower than anticipated. Overall, these results support educational efforts in this area, and the development of Canadian recommendations to improve uptake by practicing urologists.

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“…This included delayed secondary haemorrhage, which was also considered to be infection related . A significant correlation between secondary haemorrhage and urine infection at catheter removal was reported ( P < 0.05) . This was another indirect evidence of the effectiveness of the treatment of preoperative bacteriuria in controlling postoperative infections.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2014

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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.

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Antibiotic Prophylaxis and Secondary Haemorrhage Following Transurethral Resection of the Prostate: a Prospective Trial

Cited by 11 publications

References 10 publications

Secondary hemorrhage after bipolar transurethral resection and vaporization of prostate

Secondary hemorrhage after bipolar transurethral resection and vaporization of prostate

Assessment of Antibiotic Prophylaxis Prescribing Patterns for TURP: A Need for Canadian Guidelines?

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

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