Login to Access Video or Poster Abstract: MP27-09
Sources of Funding: none

Introduction

Transient non-bothersome, irritative bladder symptoms are not uncommon following HoLEP, and thus urine culture (UCx) is obtained to differentiate between expected transient irritative symptoms and urinary tract infection (UTI)._x000D_ Our aim is to evaluate the predictors and risk factors of postoperative bacteriuria at 6 weeks post HoLEP in an attempt to decrease the postoperative routine UCx analysis._x000D_ _x000D_

Methods

After IRB approval, a retrospective chart review of 100 patients who had HoLEP between August 2015 and June 2016. It is a protocol at our institution that UCx analysis is performed at the 6 weeks postoperatively. All patients had urine cultures’ results preoperatively and 6 weeks postoperatively. Patients’ demographics, Preoperative, operative and postoperative characteristics data were obtained and analyzed. Statistical analysis was performed using USPSS and included means with standard deviation, Chi-square test, and Independent T-test when appropriate.

Results

A total of 100 patients were identified, 18 patients in group (A) who had positive postoperative UCx at 6 weeks after HoLEP versus 82 patients in group (B) who had negative postoperative UCx. Patients’ demographics were comparable with no statistical significance between both cohorts. 11 (61.1%) vs 22 (26.2%) patients had preoperative positive UCx in groups (A) and (B), respectively, (p=0.052). A preoperative history of UTI was noted in 7 (38.8%) vs. 28 (34.1%) patients in groups (A) and (B), respectively, (P= 0). Preoperative Urine retention was present 3 vs. 12 in groups (A) and (B) with a mean length of catheterization (LOC) of 60 vs. 75.58 days, respectively, (p= 0.708). Mean preoperative PVR was 116.45 vs. 145.48 mls in groups (A) and (B), respectively, (p= 0.463). Mean preoperative BPH impact index was 5.85 vs. 5.1 in groups (A) and (B), respectively, (p= 0.439). Mean preoperative AUA score is 22.2 vs. 24.48 in groups (A) and (B), respectively, (P= 0.383). Mean OR specimen weight was 68.6 vs. 51.5 gms in groups (A) and (B), respectively, (p= 0.294). Enucleation and morcellation times were comparable with no statistical significance. Postoperative LOC was 1.6 vs. 1.9 in groups (A) and (B), respectively, (p=0.323). Mean postoperative PVR at 6 weeks was 77.5 vs. 45.7 mls in groups (A) and (B), respectively, (p= 0.014). Mean AUA score mean at 6 weeks was comparable at 5.66 vs. 8.2 in groups (A) and (B), respectively, (p= 0.153).

Conclusions

The sole predictor of postoperative bacteriuria is the elevated PVR; we recommend obtaining routine UCx for patients who presents with PVR above 50 ml.

Funding

none