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Related Concept Videos

Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care01:30

Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care

A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
Urinary Tract Infection IV: Nursing Management01:17

Urinary Tract Infection IV: Nursing Management

In managing urinary tract infections (UTIs) in nursing, a comprehensive assessment is essential. Begin by gathering subjective data, such as the patient’s complaints of dysuria (painful urination), urinary frequency, urgency, suprapubic pain, and any lower abdominal discomfort. This information can be complemented by questions regarding previous UTIs, sexual activity, and personal hygiene practices, which can provide insight into risk factors. Objective assessment should focus on signs like...
Urinary Tract Calculi VI: Surgical Management01:25

Urinary Tract Calculi VI: Surgical Management

Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
Kidney Transplant II: Surgical Procedure01:26

Kidney Transplant II: Surgical Procedure

Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living donor...
Urologic Endoscopic Procedure: Cystoscopic Examination01:28

Urologic Endoscopic Procedure: Cystoscopic Examination

Meaning of Cystoscopic Examination:Cystoscopy is an essential diagnostic tool in urology that is used to assess the structure and function of the genitourinary system. It provides a direct view of the urethra, bladder, and, in some cases, the ureteral openings. This procedure helps detect structural abnormalities, infections, cancers, and blockages in the urinary tract. There are two types of cystoscopy:Flexible cystoscopy is commonly performed in outpatient settings due to its less invasive...
Urine Studies II: Urine Culture and Sensitivity Test01:26

Urine Studies II: Urine Culture and Sensitivity Test

A urine culture and sensitivity test is a diagnostic procedure used to identify urinary tract bacterial infections and determine the most effective antibiotics for treatment. This test is generally preferred when a patient shows manifestations of a urinary tract infection, such as frequent or painful urination, cloudy or foul-smelling urine, or lower abdominal pain.Purpose of the TestThe primary goals of a urine culture and sensitivity test are to:Determine the specific bacteria causing the...

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Do Prophylactic Antibiotics Decrease the Rate of Urinary Tract Infections After Robot-Assisted Radical Cystectomy? A

Ahmed A Hussein1, Abdul Wasay Mahmood1, Ali Ahmad1

  • 1Department of Urology, Roswell Park Comprehensive Cancer Center, Buffalo, New York.

The Journal of Urology
|April 25, 2025
PubMed
Summary

Prophylactic antibiotics significantly reduced 90-day urinary tract infections (UTIs) and related complications after robot-assisted radical cystectomy (RARC). This approach also lowered costs without increasing adverse events, improving patient outcomes.

Keywords:
UTIbladder cancerrobot-assisted radical cystectomy

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Area of Science:

  • Urology
  • Surgical Oncology
  • Infectious Disease

Background:

  • Robot-assisted radical cystectomy (RARC) is a complex procedure for bladder cancer.
  • Urinary tract infections (UTIs) are a common complication following RARC.
  • Optimizing post-operative care to prevent UTIs is crucial for patient recovery and reducing healthcare costs.

Purpose of the Study:

  • To evaluate the efficacy of extended prophylactic antibiotic use in preventing 90-day UTIs after RARC.
  • To assess the impact of prophylactic antibiotics on infectious complications, readmissions, and costs post-RARC.

Main Methods:

  • A randomized controlled trial comparing standard of care (SOC) with 30-day prophylactic antibiotics (nitrofurantoin or trimethoprim/sulfamethoxazole) post-RARC.
  • Patients undergoing RARC with urinary diversion were included.
  • Primary endpoint was the incidence of 90-day UTIs; secondary endpoints included complications, readmissions, and costs.

Main Results:

  • The prophylactic antibiotic group showed a 0% UTI rate compared to 25% in the SOC group (P = .001).
  • Infectious complications and UTI-related readmissions were significantly lower in the antibiotic group (14% vs 43% and 5% vs 30%, respectively).
  • Mean post-cystectomy costs were reduced by $9074 in the treatment arm, with a number needed to treat of 4.0 to prevent one UTI.

Conclusions:

  • Thirty days of prophylactic antibiotics after RARC effectively prevent 90-day UTIs.
  • This strategy reduces infectious complications, readmissions, and healthcare costs associated with RARC.
  • Prophylactic antibiotics can be safely administered post-RARC without increasing adverse events.