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Antimicrobial prophylaxis in transurethral resection of the prostate. With special reference to preoperatively
1Organ-surgical Department, Aarhus County Hospital, Denmark.
Abstract:
The literature on antimicrobial prophylaxis in connection with transurethral resection of the prostate (TURP) is reviewed, and it is concluded that there is no proof of clinically significant beneficial effect of prophylaxis when the urine is sterile preoperatively. Prophylaxis is indicated when bacteriuria or an indwelling urethral catheter is present at the time of operation. Other possible risk factors, such as diabetes mellitus, neurogenic bladder dysfunction, immunosuppression, earlier coronary bypass operation and the presence of prosthetic devices, need further investigation.
Insights
Antimicrobial prophylaxis before transurethral resection of the prostate (TURP) is not proven effective for patients with sterile urine. Prophylaxis is recommended only if bacteriuria or a catheter is present.
Area of Science:
- Urology
- Infectious Disease
Background:
- Transurethral resection of the prostate (TURP) is a common surgical procedure.
- Antimicrobial prophylaxis is frequently used to prevent infections associated with TURP.
- The efficacy of prophylaxis in specific patient populations requires clarification.
Purpose of the Study:
- To review the existing literature on antimicrobial prophylaxis for TURP.
- To determine the indications for antimicrobial prophylaxis in TURP procedures.
- To identify patient groups requiring further investigation regarding prophylaxis.
Main Methods:
- Literature review of studies on antimicrobial prophylaxis and TURP.
- Analysis of evidence regarding the benefit of prophylaxis based on preoperative urine status.
- Identification of potential risk factors influencing infection rates.
Main Results:
- No evidence supports a clinically significant benefit of antimicrobial prophylaxis when preoperative urine is sterile.
- Antimicrobial prophylaxis is indicated for patients with preoperative bacteriuria or an indwelling urethral catheter.
- Factors like diabetes, neurogenic bladder, immunosuppression, prior bypass surgery, and prosthetic devices warrant further study.
Conclusions:
- Routine antimicrobial prophylaxis is not justified for TURP patients with sterile preoperative urine.
- Prophylaxis should be reserved for cases with documented bacteriuria or catheterization.
- Further research is needed to evaluate risk factors and optimize prophylaxis strategies.