Poster, Podium & Video Sessions
Presentation Authors: Michael Vainrib*, KFAR SABA, Israel
Introduction: Urodynamic study (UDS) is an invasive ambulatory procedure that carries a risk for urinary tract infection (UTI). AUA statement justifies antimicrobial prophylaxis before UDS only in patients with certain risk factors based on studies that used a rate of all types of bacteriuria as a measure of post-UDS UTI. The aim of the study was to verify a symptomatic post-UDS UTI rate and identify possible risk factors for post-UDS symptomatic UTI.
Methods: 398 patients in an IRB-approved retrospective review of UDS clinic electronic charts' database. Anyone with symptoms of: dysuria, urinary frequency, urgency or fever and a positive urine culture within 15 days after UDS considered as post-UDS symptomatic UTI. Following variables: age >70, male gender, past or current smoking, diabetes mellitus, neuropathic pathologies, indwelling or intermittent catheters, time interval between urine culture (UC) and a day of UDS, presence of asymptomatic bacteriuria pre-UDS were verified as possible risk factors for post-UDS UTI.
Results: Mean age of a study population was 65.7 (range=19-95) years old. 243/398(61.1%) were male. 320(80.4%) patients had a negative UC prior to UDS with a significantly lower symptomatic UTI rate of 5% compared to 14.7% symptomatic UTI rate among patients who had prior to UDS appropriately treated positive UC (p<0.02). There was no significant difference in a time interval between UC and a date of UDS in a group that developed UTI compared to an asymptomatic group (p=0.1). In a univariate analysis, age >70, appropriately treated UC before UDS, time interval between UC and UDS more than a week, male gender, diabetes mellitus and neuropathic conditions were found as a significant variables predicting post-UDS symptomatic UTI (p<0.0001). However, in a multivariate analyses, only an appropriately treated positive UC before UDS (OR=2.75, 95%CI=1.04-7.27, p=0.04) and an interval of more than a week between pre-UDS UC and UDS (OR=2.83, 95%CI=1.16-6.91, p=0.022) were found as significant variables predicting symptomatic post-UDS UTI.
Conclusions: The first study to verify a symptomatic post-UDS UTI rate and identify possible risk factors for post-UDS symptomatic UTI. This study supports our antimicrobial prophylaxis protocol before UDS to minimize post-UDS UTI rate. However, a retrospective design and a relatively small number of patients in each group of proposed risk factors might cause that only few risk factors were with significance were found in a multivariate analysis.
Source Of Funding: none
Meir Medical Center
2012-now - Head of Neurourology Unit, Meir Medical Center affiliated to Tel-Aviv University, Israel
2011-2012 - Visiting Assistant Professor (Female Urology, Neurourology and Pelvic Reconstruction Fellowship), University of Southern California, Los Angeles
2003-2009 - Urology Residency, Meir Medical Center affiliated to Tel-Aviv Universit, Israel
1995-2003 - MD Degree, Technion, Israel
Sunday, May 14
3:30 PM – 5:30 PM