Prevalence of bacteriuria and treatment outcomes in patients with symptomatic benign prostatic hyperplasia: a prospective observational study.

Introduction: The global incidence of benign prostatic hyperplasia (BPH) is rising, with bacterial causes of lower urinary tract symptoms (LUTS) being a common factor contributing to complications in these patients.

Aim: To identify the prevalence of bacteriuria and treatment response in patients with symptomatic BPH.

Materials and methods: This 1-year prospective study included all patients presenting with LUTS due to BPH who met the inclusion criteria. Urine samples were collected and analyzed for microscopy, culture, and sensitivity following standard protocols. Bacterial growth in urine specimens and International Prostate Symptom Score (IPSS) of LUTS were recorded before and after antibiotic therapy.

Results: A total of 131 patients with symptomatic BPH were studied. Escherichia coli (47.6%) was the most commonly isolated bacteria, followed by Klebsiella pneumoniae and Pseudomonas species. E. coli and Klebsiella showed the highest sensitivity to nitrofurantoin. After 1 week of antibiotic therapy, 69% of patients had sterile urine cultures, while 31% remained E. coli positive. Significant improvement in IPSS scores was observed after 1 week of therapy (P<0.05), and there was no significant change in urine culture (P=0.854).

Conclusion: Bacteriuria is a common finding in patients with symptomatic BPH in our setting. Escherichia coli and Klebsiella pneumoniae were the most frequently isolated organisms, with sensitivity to nitrofurantoin and cefixime. A week of antibiotic therapy significantly reduced IPSS scores but did not reduce bacteriuria.