Clinical Research On The Relations Between Indwelling Catheters And Urinary Tract Infection After Turp

ObjectivesBenign prostatic hyperplasia(BPH) is a common disease found in elderly males. Transurethral resection of the prostate(TURP) has been frequently used to treat BPH. The advantages of less injury, less pain to patients and its security and effectiveness make it widely used in the surgical treatment of BPH and it is still the “golden standard” in the operative treatment to lower urinary tract symptoms(LUTS) BPH 【1】.But due to patients’ old age, large amounts of chronic internal medical diseases and lack of standardization in operation, postoperative complications often turn up after TURP with a higher morbidity of urinary tract infection(UTI)(about 18.7%) 【2,3】. UTI not only influences patients’ recovery but also prolongs their hospital stays and increases their pain. Indwelling urinary catheters are one of the most important reasons for UTI. Methods of placing a urinary catheter, the time a urinary catheter stays in a urinary tract and the material of urinary catheters are all associated with UTI.Analyze the risk factors between indwelling urinary catheters and UTI; summarize the measures for prevention and clinical treatment.MethodsThe urinary surgery department of the People’s Hospital of Donge, Shandong Province randomly selected 116 cases from BPH patients who underwent TURP from January, 2012 to December, 2013. According to diagnosis standard for hospital infection, 4 cases had been diagnosed with UTI before operation, so they are excluded from the group. Among the rest 112 cases, 22 cases are infected with UTI with an age from 56 to 91 and an average age of 72.6. Conduct a prospective study and systemize the data of patients’ clinical features and infection rate after operation; analyze the risk factors of postoperative UTI; summarize the measures for prevention and clinical treatmentResultsAccording to the time of indwelling urinary catheters, we divided the 112 cases into groups of 3 days, 5 days and 7days and found that 2, 7 and 13 cases were infected with UTI in each group with an infection rate of 5.0%, 19% and 34%. Among these cases, there were 38 patients with preoperative combining basic internal medical diseases(hypertension or diabetes) of whom 13 cases were infected with UTI. There were also 30 patients who underwent catheterization before operation because of uroschesis of whom 14 cases were infected with UTI. The study found that diabetes and catheterization as a result of uroschesis before operation, long time of operation and long stay of indwelling urinary catheters are all risk factors of UTI after TURP.ConclusionsUTI is a common complication after TURP. It’s associated with age, stay time of indwelling urinary catheters, material of urinary catheters and combining internal medical diseases. The shorter time urinary catheters stay in urinary tracts, the lower the morbidity of postoperative asymptomatic bacteriuria and symptomatic bacteriuria is. The morbidity of urethrostenosis, cystorrhagia and acute uroschesis after the removing of urinary catheters has not increased, which is of no statistical significance. Actively treating and controlling internal diseases before operation, removing urinary catheters as early as possible after operation, shortening the time urinary catheters stay in urinary tracts and choosing silicone rubber urinary catheters can reduce the morbidity of postoperative UTI. Antibiotic treatment to patients according to their urine culture and drug allergy results can reduce the morbidity of symptomatic bacteriuria.