Transurethral resection of the prostate without routine antibiotic prophylaxis: screening for complications

In a prospective study of 61 patients undergoing transurethral resection of the prostate without antibiotic prophylaxis there were no major postoperative complications in 55 cases (90%). A bacteriological screen involving culture of a preoperative sample of urine, an immediate preoperative urethral swab, prostatic chippings, immediate postoperative blood cultures and catheter-removal sample of urine was carried out to investigate the ability to detect infective complications. The blood cultures had a predictive value of 80% (sensitivity 80%, specificity 93%). However, the result was available in time to influence management in only one of four patients with postoperative septicaemia.