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[Infectious risks of outpatient cystoscopy in men with sterile urine]
P M Lugagne1, J M Hervé, T Lebret
1Service d'Urologie, CMC Foch, Suresnes, France.
Objective:
To prospectively assess the inherent risk of infection associated with outpatient cystoscopy performed in men with sterile urine without antibiotic prophylaxis.
Material And Methods:
298 cystoscopies were performed in men corresponding to these criteria, with the exclusion of patients at risk of bacterial endocarditis. The equipment consisted of three cystoscopes prepared according to the recommendations of the Société Française d'Hygiène Hospitalière. The disease justifying the examination was specified for each patient. The sterility of the urine was verified during the week preceding the examination and 48 hours later by urine culture.
Results:
Out of 281 evaluable patients, an infection was observed in 22 cases (7.8%), and was symptomatic in only one case. Escherichia coli was the organism most frequently isolated (50%) and no multiresistant bacteria were detected. A particularly high infection rate was observed in enterocystoplasty patients (21.7%).
Conclusion:
The infectious risk of cystoscopy in the presence of sterile urine, performed according to recommendations, appears to be higher than previously reported. This risk appears to be significantly higher in the case of enterocystoplasty than for other diseases.
Insights
Outpatient cystoscopy in men with sterile urine has a higher infection risk (7.8%) than previously thought. Patients with enterocystoplasty face a significantly elevated risk of post-procedure infection.
Area of Science:
- Urology
- Infectious Diseases
- Surgical Risk Assessment
Context:
- Outpatient cystoscopy is a common urological procedure.
- Antibiotic prophylaxis is often used to prevent infections.
- The inherent risk of infection without prophylaxis requires evaluation.
Purpose:
- To prospectively evaluate the infection risk associated with outpatient cystoscopy in men with sterile urine.
- To determine the incidence of symptomatic and asymptomatic infections.
- To identify specific patient groups with higher infection rates.
Summary:
- A prospective study of 298 men undergoing outpatient cystoscopy without antibiotic prophylaxis found an infection rate of 7.8% in 281 evaluable patients.
- Escherichia coli was the most common pathogen, and no multiresistant bacteria were detected.
- Patients who underwent enterocystoplasty had a significantly higher infection rate (21.7%).
Impact:
- The findings suggest that the infectious risk of cystoscopy, even with sterile urine and adherence to recommendations, may be underestimated.
- Enterocystoplasty patients represent a high-risk group requiring specific consideration for infection prevention strategies.
- This study informs clinical practice regarding the necessity and potential benefits of antibiotic prophylaxis in certain patient populations undergoing cystoscopy.