Prevalence and predictive factors of complicated urinary tract infections post bladder and prostate transurethral resections.

Purpose: Complicated urinary tract infections (UTI) after transurethral resection of bladder or prostate tumor (TURBT, TURP) are one of the most frequent and significant complications. However, recommendations for pre-operative antibiotic prophylaxis and treatment of asymptomatic bacteriuria differ greatly. This study aims to determine the prevalence of complicated UTI following TURP and TURBT. The secondary objective is to identify pre and postoperative risk factors associated with complicated UTI.

Methods: A retrospective institutional cohort study was conducted by analyzing records of patients who had either a TURP or a TURBT between January 2020 and December 2021 at the Centre intégré universitaire de santé et de services sociaux de l'Estrie-Centre hospitalier universitaire de Sherbrooke (CIUSSE-CHUS). The prevalence of complicated UTI requiring hospitalization up to 30 days after surgery and associated risk factors were recorded.

Results: Out of the 701 patients included, 579 (82.6%) were men and the median age was 72.9 years (IQR: 67-79). In total, 505 (72.0%) patients had undergone a TURBT while 196 (28.0%) had a TURP. Readmission for a complicated UTI was necessary in 16 (2.3%) patients. American Society of Anesthesiologists scores of 3 and 4 were significantly associated with a higher prevalence of post-operative complicated UTI (OR 3.39; CI 1.21-10.8; p = 0.025).

Conclusion: The prevalence of complicated UTI after TURBT and TURP is relatively low. However, patients with more comorbidities are at greater risk of serious post-operative infectious complications. Antibiotic regimen for patients with pre-operative asymptomatic bacteriuria should therefore be further personalized.