在内镜前列腺手术前进行例行尿培养检测是否会降低术后尿路感染? 对退伍军人事务外科质量改善计划的分析
Muhieddine Labban1, William J O'Brien2, Kalpana Gupta2,3
1Department of Urological Surgery, Brigham and Women's Hospital, Havard Medical School, Boston, Massachusetts.
Urology practice
|June 19, 2025
概括
常规的手术前尿培养 (UCX) 在内镜前列腺手术中没有减少术后的尿路感染. 阳性UCX病史增加了尿路感染的风险,无论手术前的检测如何.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 手术感染 手术感染
- 改善医疗质量 改善医疗质量
背景情况:
- 内镜前列腺手术带有感染性并发症的风险.
- 泌尿病学指南建议进行手术前的尿液检测,但尿液培养 (UCX) 的实用性尚不清楚.
研究的目的:
- 为了确定手术前尿培养 (UCX) 测试是否减少手术后尿路感染 (UTI) 在接受内镜前列腺手术的男性.
主要方法:
- 对22825名接受内镜前列腺手术 (2015-2022) 的男性进行了回顾性分析.
- 在30天内对术后尿道感染进行评估.
- 确定与手术前UCX和手术后UTI相关的因素.
主要成果:
- 手术前的UCX与手术后的尿路感染风险降低无关 (aOR = 0.89;P = .29).
- 一年内呈阳性UCX病史是术后尿路感染的最强预测因素 (aOR = 1.33;P = .001).
- 激光核切除 (LEP) 与通过尿道切除前列腺 (TURP) 相比,与较低的尿路感染风险相关 (aOR = 0.56;P = .031).
结论:
- 常规的手术前UCX测试与内镜前列腺手术中术后尿路感染风险的降低无关.
- 具有阳性UCX病史的患者仍然面临术后尿路感染的更高风险,这表明需要采用替代治疗策略,可能包括更广泛的抗生素.
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