William Mathez, Victor Briche, Antoine Vincentelli, Franck Bruyère, Ali Bourgi
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引用次数: 0
Abstract
Background: Intravesical mitomycin C (MMC) is widely used after transurethral resection of bladder tumor (TURBT) and as adjuvant therapy for non-muscle-invasive bladder cancer (NMIBC). Despite its favorable safety profile, many institutions continue to require systematic urine culture before each instillation, although supporting evidence is limited.
Objective: To evaluate the clinical utility of routine urine culture before intravesical MMC instillation and to assess its association with post-instillation urinary infectious complications.
Methods: We conducted a retrospective instillation-based analysis of all intravesical MMC instillations performed at our institution between June 2022 and June 2025. A total of 720 consecutive instillations performed in 78 patients were analyzed. Pre-instillation urine cultures were systematically obtained and classified as negative, polymicrobial, single-organism cultures, or two-organism cultures. The primary outcome was the occurrence of post-instillation urinary infectious complications within 30 days, defined as febrile urinary tract infection, hospitalization for urinary infection, or sepsis, bacteremia.
Results: Among 720 MMC instillations, 639 (88.8%) pre-instillation urine cultures were negative and 81 (11.2%) were non-negative (47 polymicrobial, 26 single-organism cultures, 8 two-organism cultures). Three urinary infectious complications (0.4%) were observed, all occurring in patients with negative pre-instillation urine cultures. No urinary infectious complications occurred in patients with positive urine cultures.
Conclusion: In this retrospective cohort, routine pre-instillation urine culture appeared to have limited clinical utility for predicting subsequent urinary infectious complications. Although these findings support a symptom-based approach in asymptomatic patients, larger prospective studies are needed before definitive recommendations can be made.
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