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Bacteriuria After Diagnostic Flexible Cystoscopy Without Antibiotic Prophylaxis: A Prospective Study.

Tsia-Shu Lo1,2,3,4, Chean-Wen Li5, Ai-Leen Ro6

  • 1Division of Urogynecology, Department of Obstetrics and Gynecology, Linkou, Chang Gung Memorial Hospital, Linkou Medical Center, 5, Fu-Hsin Street, Kwei-Shan, Tao-Yuan City, Taiwan, 333. 2378@cgmh.org.tw.

International Urogynecology Journal
|March 26, 2026
PubMed
Summary

Flexible cystoscopy is safe for women, with a low 1.3% incidence of bacteriuria when using ortho-phthalaldehyde for high-level disinfection (HLD). Proper reprocessing protocols ensure the effectiveness of HLD for cystoscopes.

Keywords:
BacteriuriaFlexible cystoscopyHigh-level disinfectionTransurethral catheterizationUrinary tract infection

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Area of Science:

  • Urology
  • Infectious Disease
  • Medical Device Reprocessing

Background:

  • Flexible cystoscopy is a common procedure for diagnosing lower urinary tract conditions in women.
  • Effective reprocessing of cystoscopes is crucial to prevent healthcare-associated infections.
  • High-level disinfection (HLD) is a standard for reprocessing semi-critical medical devices like cystoscopes.

Purpose of the Study:

  • To evaluate the incidence of bacteriuria following flexible cystoscopy.
  • To assess the efficacy of ortho-phthalaldehyde (OPA) for high-level disinfection of flexible cystoscopes.
  • To determine the safety of flexible cystoscopy in women when using OPA-based HLD.

Main Methods:

  • A prospective study included 78 women undergoing outpatient flexible cystoscopy.
  • Exclusion criteria included existing urinary tract infections or bleeding disorders.
  • Urine cultures were obtained before and immediately after cystoscopy; cystoscopes were reprocessed using ortho-phthalaldehyde.

Main Results:

  • One woman (1.3%) developed post-cystoscopy bacteriuria.
  • The mean age of participants was 58.7 years.
  • The most common indication for cystoscopy was hematuria (58.4%).

Conclusions:

  • The incidence of bacteriuria after flexible cystoscopy using OPA HLD is low (1.3%).
  • Ortho-phthalaldehyde is an effective agent for HLD of flexible cystoscopes.
  • Maintaining rigorous reprocessing protocols (rinsing, drying, exposure tracking) is essential for HLD efficacy.