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Transurethral resection of the prostate (TUR-P) and associated risk of infective endocarditis

Emil Loldrup Fosbøl1,2, Anna Stahl3, Andreas Røder4

  • 1The Heart Center, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. emil.fosboel@regionh.dk.

Infection
|December 20, 2024
PubMed
Abstract

Insights

Transurethral resection of the prostate (TUR-P) surgery significantly increases the risk of infective endocarditis (IE) within six months. While the absolute risk remains low, this finding highlights the need for improved prophylactic strategies to prevent IE after TUR-P.

Area of Science:

  • Urology
  • Infectious Diseases
  • Cardiology

Background:

  • Bacteremia is a known surgical complication that can lead to infective endocarditis (IE).
  • Transurethral resection of the prostate (TUR-P) can cause bacteremia, but its specific risk for IE is not well-established.
  • Understanding the IE risk following TUR-P is crucial for patient management and preventative measures.

Purpose of the Study:

  • To investigate the risk of developing infective endocarditis (IE) after undergoing Transurethral resection of the prostate (TUR-P).
  • To compare the incidence of IE in patients who had TUR-P with an age-matched control group from the general population.

Main Methods:

  • A cohort study comparing 25,781 patients undergoing TUR-P between 2010 and 2020 with an age-matched control group.
  • Patients were monitored for IE development within 6 months and 6-12 months post-TUR-P.
  • Statistical analysis involved cumulative incidences and time-dependent Cox regression models.

Main Results:

  • The incidence of IE was significantly higher within 6 months after TUR-P compared to the background population (adjusted HR 8.16).
  • Enterococcus faecalis was the most common pathogen identified in IE cases (72.7%).
  • The elevated risk for IE diminished between 6-12 months post-TUR-P (adjusted HR 2.15).

Conclusions:

  • Transurethral resection of the prostate (TUR-P) is associated with an eight-fold increased risk of infective endocarditis (IE) within 6 months post-surgery.
  • Despite the low absolute risk, TUR-P is a significant risk factor for IE.
  • Further research into enhanced prophylactic interventions for IE following TUR-P is warranted.
Keywords:
BacteremiaInfective endocarditisMicrobiologyProstate hyperplasiaTUR-P

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