Urinary tract infection after retrograde urethrogram in children: A multicenter study.

Area of Science:

• Urology
• Pediatric Urology
• Infectious Disease

Background:

• The risk of post-procedural urinary tract infection (ppUTI) following retrograde urethrogram (RUG) is not well-established.
• Prophylactic antibiotics may lower ppUTI risk but raise concerns about antibiotic resistance.
• Existing data on ppUTI rates after similar procedures (voiding cystourethrogram, urodynamics) show variability and low incidence, respectively.

Purpose of the Study:

• To quantify the incidence of ppUTI after RUG in pediatric patients.
• To identify clinical factors associated with the administration of prophylactic antibiotics during RUG.

Main Methods:

• Retrospective cohort study of pediatric patients undergoing RUG between January 1, 2004, and December 31, 2014.
• Data collected on patient demographics, indications for RUG, and antibiotic prophylaxis.
• ppUTI occurrence within 7 days post-procedure was the primary outcome.

Main Results:

• A total of 47 RUGs were performed on 42 male patients (median age 11.7 years).
• Indications included trauma, hypospadias, and urethral stricture.
• One patient (2.1%) developed a ppUTI; this patient had a history of posterior urethral valves and voiding dysfunction.

Conclusions:

• The incidence of ppUTI after RUG in this pediatric cohort is low.
• Pre-procedural antibiotic use was not correlated with a lower risk of ppUTI.
• Findings suggest the need for evidence-based guidelines to reserve antibiotic prophylaxis for high-risk patients undergoing RUG.