[Contamination during transurethral manipulations of the upper urinary tract]

A four-year observation was carried out on a series of 289 patients who had undergone miscellaneous transurethral operations and manipulations on the upper urinary tract. Clinical and microbiological studies were performed in an attempt to record the incidence of urinary tract infections as a consequence of contamination following transurethral manipulations. Random groups of in-lying patients at two urologic clinics served as controls. It was found that the hazard of contamination with pathogenic bacteria causative agents of urinary tract infections in the study group was smaller than usually believed. The mean infection rate was 17.3 per cent, vs. 35.6 and 45.5 per cent respectively in the control groups. Higher was the risk of contamination after manipulations terminating without temporary drainage of the urine from the upper urinary tract. In the contamination processes was involved a broader spectrum of microorganisms with more resistant strains. Conclusions are drawn on the possibilities to reduce the contamination levels and to prevent the consequences of infection. This should be achieved not by limiting the manipulations, but by mastering the endoscopic technique and nontraumatic work with this technique.