Urinary tract infections in connection with transurethral resection of the prostate

The study evaluates the incidence and consequences of infectious complications after 700 transurethral resections of the prostate. The patients were treated individually for bacteriuria according to urine cultures. No general antibacterial prophylaxis was used. 376 patients (54%) had negative urine cultures throughout the course and received no antibacterials. Of the 256 patients with an indwelling catheter before surgery only 64 (25%) had negative cultures throughout, as opposed to 312 (70%) out of 444 patients without an indwelling catheter preoperatively. Antibacterial treatment was given to 127 patients (18%) before surgery because of bacteriuria. Positive urine cultures postoperatively indicated antibacterial therapy to 197 patients (28%). Four non-fatal cases of septicemia were recorded. The influence of bacteriuria and indwelling catheters on the postoperative course and on the length of hospital stay is documented. It is concluded that antibiotic prophylaxis may be indicated in patients with a preoperative urethral catheter; other patients should be treated if and when bacteriuria occurs.