Urogenital Tract Infection

Postoperative Microscopic Pyuria and Role of Damage-Associated Molecular Pattern: A Literature Review: Min-Kyu Kim, Ki Hong Kim; Urogenit Tract Infect 2024;19(3):73-79. Published online December 31, 2024; DOI: https://doi.org/10.14777/uti.2448026013

Abstract PDF PubReader ePub: All patients who undergo transurethral prostate surgery exhibit pyuria and microscopic hematuria in postoperative urinalysis. Postoperative asymptomatic pyuria is associated with the inflammatory process and surface remodeling of the prostate, rather than infection. Various studies have investigated the incidence, duration, and risk factors for postoperative pyuria, noting that factors like age, surgery time, and prostate size can influence outcomes. Postoperative pyuria reflects tissue recovery and inflammation, and the use of antibiotics in asymptomatic patients may not be appropriate.

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Treatment Modality of Prostatic Abscess according to Size: A Retrospective Study: Gwon Kyeong Lee, Kyoung Ha Jang, Woo Seop Seong, Byeong Jin Kang, Kyung Hwan Kim, Hong Koo Ha; Urogenit Tract Infect 2022;17(3):96-102. Published online December 31, 2022; DOI: https://doi.org/10.14777/uti.2022.17.3.96

Abstract PDF PubReader ePub: Purpose: This study aimed to determine the treatment modality for prostatic abscesses according to size.
Materials and Methods: Twenty-five patients diagnosed with prostatic abscesses were retrospectively reviewed. All patients were treated with intravenous empirical and appropriate antibiotics according to culture results. They were grouped according to the size of the prostate abscess based on computed tomography results (group A, with prostate abscess ≤2 cm, n=10; group B, with prostate abscess size >2 cm, n=15), and their treatment modality and outcomes were compared.
Results: The prostatic abscess sizes were 1.31±0.37 and 3.49±1.06 cm for groups A and B, respectively. Prostate-specific antigen, prostatic volume, and comorbidity were not significantly different (p>0.05), whereas pelvic pain was significantly different (p=0.028). There was no difference in the microorganisms isolated from urine and blood culture, empirical antibiotics, and broad-spectrum antibiotics between the two groups (p>0.05). More patients in group B underwent transurethral abscess deroofing than those in group A (p=0.040). Patients in group B had a more extended hospitalization period and intravenous antibiotics duration than those in group A (p=0.024 and p=0.013, respectively). Group B had more cases of septic shock, intensive care unit admission, and mortality events than group A (p=0.024, p=0.001, and p=0.061, respectively). However, prostatic abscess recurrence and urological chronic complication did not significantly differ (p>0.05).
Conclusions: Appropriate use of antibiotics is crucial. This study shows that the treatment of patients with prostatic abscess >2 cm is more difficult, but transurethral abscess deroofing can lower mortality, prostatic abscess recurrence, and urological chronic complications.

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Korean Multicenter Study of Infectious Complications after Transurethral Prostate Surgery in Patients with Preoperative Sterile Urine: Seong Hyeon Yu, Seung Il Jung, Eu Chang Hwang, Tae-Hyoung Kim, Jae Duck Choi, Koo Han Yoo, Jeong Woo Lee, Dong Hoon Koh, Sangrak Bae, Seung Ok Yang, Joongwon Choi, Seung Ki Min, Hoon Choi; Urogenit Tract Infect 2022;17(3):81-88. Published online December 31, 2022; DOI: https://doi.org/10.14777/uti.2022.17.3.81

Abstract PDF PubReader ePub: Purpose: To evaluate the efficacy of antibiotic prophylaxis and determine the risk factors of infectious complications after transurethral surgery of the prostate.
Materials and Methods: Seven hundred and seventy-two patients who underwent transurethral resection of the prostate (TURP) or holmium laser enucleation of the prostate (HOLEP) were reviewed. Of these, this study enrolled 643 patients without bacteriuria who had not received antibiotics for urinary tract infections for two weeks before surgery. The patients were divided into two groups according to the duration of the antibiotics (Group 1: less than one day, n=396 vs. Group 2: more than one day, n=247).
Results: The overall incidence of postoperative infectious complications in 643 patients was 5.0% (32/643). When postoperative infectious complications were compared according to the duration of the antibiotics (Group 1 vs. Group 2), the infectious complications rates were 5.6% (22/396) vs. 4.0% (10/247), respectively (p=0.393). When postoperative infectious complications were compared according to the duration of antibiotics (Group 1 vs. Group 2) in the TURP and HOLEP groups, the infectious complications rates were 6.3% (12/192) vs. 1.0% (1/103) (p=0.035) and 4.9% (10/203) vs. 6.0% (8/134) (p=0.677), respectively. The duration of Foley catheterization was independently associated with infectious complications (p=0.003).
Conclusions: The results showed that prolonged postoperative catheterization affects postoperative infectious complications associated with transurethral prostate surgery. Although antibiotics administered for less than one day are effective for antibiotic prophylaxis of transurethral prostate surgery, a longer antibiotic therapy is recommended for TURP.

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Von Brunn’s Nest in an Incidental Bladder Mass Found during Holmium Laser Enucleation of the Prostate: Seungsoo Lee; Urogenit Tract Infect 2020;15(1):13-15. Published online April 30, 2020; DOI: https://doi.org/10.14777/uti.2020.15.1.13

Abstract PDF PubReader ePub: A 62-year-old male with benign prostatic hyperplasia underwent holmium laser enucleation of the prostate. During surgery, a small nodular mass was found incidentally in the trigone of the bladder. The lesion was removed completely by a transurethral resection with a bipolar device. A pathology examination of the lesion indicated von Brunn’s nests.

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