Infectious complications after instrumentation of urinary tract

Urethral catheterization is the single most important predisposing factor in the development of nosocomial urinary tract infection. Infection rates, etiologies, and possible methods of prevention are reviewed. Cystoscopy may be followed by a transient bacteremia. It is recommended that patients with positive urine cultures who undergo diagnostic cystoscopy receive antibiotic prophylaxis, but this is not required in patients with sterile urine. The incidence of urinary tract infection following transurethral surgery in patients who have not been given prophylactic antibiotics ranges from 6 to 60 per cent. The value of antibacterial prophylaxis in TUR, is still somewhat controversial. The incidence of infection and the value of antibacterial prophylaxis in prostatic biopsy appear to be related to the technique (transperineal or transrectal) used for the biopsy. It is too early to assess the infection risks associated with relatively new urologic procedures, such as ureteroscopy and percutaneous nephrostomy. Nevertheless, any procedure that crushes or manipulates a potentially bacteria-harboring stone carries at least a theoretical risk of infection.