The catheterized patient undergoing transurethral resection of the prostate: a survey of the current practice of British urologists

Wilson, Jim; Puri, Rajiv; Urwin, G. H.

doi:10.1046/j.1464-410x.2003.04429.x

Cited by 9 publications

(8 citation statements)

References 14 publications

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“…Transurethral prostatectomy is still a novel procedure in most government hospitals in Sub-Saharan Africa due mainly to non-availability of equipments and inadequate number of trained personnel conversant with the procedure. Patients' perception of high post-operative morbidity and mortality associated with open prostatectomy in t he locality makes the majority of them reluctant to present early for appropriate therapy as evidenced by the large number presenting with urethral catheter in situ in our series (83.1%) compared with 24% in North America and 42% in the United Kingdom [ 2 ]. The high incidence of urethral catheterisation is known to be associated with 100% bacteriuria and urinary tract infections (UTI) when catheter remains in situ for ≥ 4 days [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Transurethral resection of the prostate in Northern Nigeria, problems and prospects

et al. 2008

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BackgroundBenign prostatic hyperplasia (BPH) is the commonest disease of the urinary tract afflicting the ageing male and is the commonest neoplastic disease in men aged 50 years and above.Transurethral prostatectomy (TURP) is the ultimate treatment of choice for benign prostatic hyperplasia (BPH) due mainly to the preference of minimally invasive surgery, long term relief of symptoms and cost effectiveness. It is however not available to the majority of Nigerians in need of prostatic surgery in Public Health Institutions.MethodsThe records of patients who underwent prostatectomy in Aminu Kano Teaching Hospital, over the period June 2001 to July 2007 were examined. The bio data of patients and laboratory investigations performed were retrieved.ResultsFive Hundred and forty two patients were operated upon, out of which 40 were excluded due to open prostatectomy (22 patients), bladder neck stenosis (16 patients) or bladder tumour around the trigon (2 patients). The age range of the patients was 47–110 years with a mean of 67.2 years. 289 patients (80.1%) had urethral catheter in situ at presentation and 11 (3%) patients had suprapubic cystostomy of which only 3 (0.85%) had combined urethral stricture and BPH.Only 131 (26%) had their PSA measured which ranged from 2–100 ng/ml out of which 39(29.8% n = 131) patients had more than 4 ng/ml and cancer of the prostate and 1(0.8%, n = 131) patient had a PSA level of 4 ng/ml and malignant prostate.Hospital stay was 1–32 days (mean 7.9) and the mean follow up period was 5.6 months (range 0–60) and there were 17.5% complications comprising of urinary tract infection (UTI) 7.2%, Orchitis 2.2%, urinary incontinence 0.6%, atonic bladder 1%, erectile dysfunction 0.6%, cerebrovascular accident 0.4%, myocardial infarction 0.4%, deep vein thrombosis 0.4% and disseminated intravascular coagulopathy (DIC) 0.6% and 1.2% mortality. The cost of treatment inclusive of pre-admission investigations was US$ 615.00 (range US$ 300–1,300)ConclusionDespite advances in minimally invasive therapy for LUTH/BPH, TURP is the optimum treatment of choice for the ageing male of sub-Saharan Africa. It is however not available to the majority of patients in this region due to poor health allocation and inadequate facilities and training.

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Section: Discussionmentioning

confidence: 99%

Transurethral resection of the prostate in Northern Nigeria, problems and prospects

et al. 2008

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“…While this has not been previously described, surveys of urologists have highlighted the significantly varied choice of agent used as prophylaxis. 27 Similarly, we also observed diverse antibiotic regimens in this patient population, again highlighting a lack of consensus among urologists for optimal choice of agent (Fig. 3).…”

Section: Discussionmentioning

confidence: 68%

“…The use of gentamicin significantly increased for patients with indwelling catheters, suggesting the preferential use of this agent in this setting; this finding was also consistent with previous studies. 27 Compliance with the AUA BPS was also quantified for patients with indwelling catheters. We interpret the AUA BPS to suggest that patients with indwelling catheters require two antibiotics from different classes prior to TURP.…”

Section: Discussionmentioning

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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“…The European collaborative study of antibiotic prophylaxis for TURP [6] concluded that even patients with sterile urine preoperatively benefit from antibiotic prophylaxis and that it should be considered for all patients undergoing TURP routinely [6] . But still there is still debate about prophylaxis for patients undergoing TURP [7][8][9] .…”

Section: Introductionmentioning

confidence: 99%

A Prospective Randomized and Placebo-Controlled Study for the Evaluation of Antibiotic Prophylaxis in Transurethral Resection of the Prostate

Öztürk¹,

Koca²,

Kaya³

et al. 2007

Urol Int

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Aim: To evaluate the risk of bacteriuria after transurethral resection of the prostate and the preventive effects of different kinds of antibiotics. Patients and Methods: Urine was collected for culturing 1 week before the operation and on postoperative days 2 and 10. The patients were divided into four groups: group 1 patients were given a first-generation cephalosporin (cefazolin 1 g), group 2 patients received a second-generation cephalosporin (cefuroxime 750 mg), group 3 patients were given a third-generation cephalosporin (ceftazidime 1 g), and group 4 patients received a placebo. Results: The 2nd-day postoperative bacteriuria rates were similar in all groups. On the 10th day, the incidence rates of bacteriuria in group 4 and group 1 patients were 40 and 31%, respectively (p = 0.661). In group 2, the bacteriuria incidence rate was 6.6%, and when compared with the placebo group, the difference was considered significant (p = 0.002). The difference between group 3 and group 4 was also significant (p = 0.003). There were statistically significant differences between group 1 and group 2 (p = 0.008) and between group 1 and group 3 (p = 0.01). Conclusions: Our study demonstrated that postoperative bacteriuria incidence rates are high, even in patients who underwent transurethral resection of the prostate with sterile urine, but it can be reduced by using antibiotic prophylaxis with cefuroxime or ceftazidime.

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The catheterized patient undergoing transurethral resection of the prostate: a survey of the current practice of British urologists

Cited by 9 publications

References 14 publications

Transurethral resection of the prostate in Northern Nigeria, problems and prospects

Transurethral resection of the prostate in Northern Nigeria, problems and prospects

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

A Prospective Randomized and Placebo-Controlled Study for the Evaluation of Antibiotic Prophylaxis in Transurethral Resection of the Prostate

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