Influence of urological irrigation fluids on urothelial bacterial adherence

The influence of various urological irrigation solutions on bacterial growth and adherence to urothelium was investigated in in vitro and guinea pig models. The irrigation solutions glycine 1.5%, glycine 1.5% and ethanol 1%, glycerol 3%, mannose 6%, sorbitol 2.7% and mannitol 0.54% all inhibited bacterial growth compared with normal saline. In guinea pigs, the influence on bacterial adherence of four irrigation solutions (glycine 1.5%, glycine 1.5% and ethanol 1%, mannose 6%, povidone-iodine) was investigated using two different strains of E. coli. After cauterizing one side of the bladder and inoculation with 2.7 x 10(8) colony forming units under high or low pressure, the bladder was irrigated with the irrigation solutions. There was a stronger adherence of E. coli O6 (with type I pili) than of E. coli ATCC 25922 (without type I pili) to bladder urothelium, particularly to the injured side. There was no significant difference between the high- and low-pressure groups. None of the various irrigation solutions was clearly superior. As mannose 6% effectively inhibited type I pili and also had some antibacterial activity it may reduce urinary tract infection if used as irrigation solution.