Bacteriuria After Bipolar Transurethral Resection of the Prostate: Risk Factors and Correlation With Leukocyturia

OBJECTIVES To analyze the risk factors of postoperative bacteriuria and the correlation with leukocyturia after bipolar transurethral resection of the prostate (TURP). METHODS A total of 121 noncatheterized patients with sterile preoperative urine undergoing bipolar TURP for benign prostatic hyperplasia (BPH) were entered into the prospective study. All patients received antibiotic prophylaxis with ceftriaxone. Two urine specimens of each patient, one for urinalysis (urinary leukocyte count) and one for urine culture, were collected on removal of the catheter, 1 and 4 weeks after surgery. The risk factors of postoperative bacteriuria and correlation with leukocyturia were investigated. RESULTS The incidence of bacteriuria after bipolar TURP was 18.2% (22/121). Multivariate analysis documented 3 independent risk factors of postoperative bacteriuria: operating time >60 minutes (P = .014), duration of catheterization >3 days(P = .001), and disconnection of the closed urine drainage system (P <10(-3)). The mean leukocyte counts in urine were 405.3, 389.5, and 113.8/mu L on removal of the catheter, 1 and 4 weeks after surgery, respectively. Of 363 urine specimens, the mean concentration of leukocytes with and without bacteriuria were 323.9 and 297.6/mu L, respectively (P >.05). There was no significant correlation between bacteriuria and leukocyturia (>10 leukocytes/high power field (P >.05). CONCLUSIONS The results of our study have shown that the operating time, duration of catheterization, and disconnection of the closed urine drainage system may influence the occurrence of bacteriuria after bipolar TURP, and leukocyturia cannot reflect the possibility of postoperative bacteriuria. UROLOGY 77: 1183-1187, 2011. (C) 2011 Elsevier Inc.