The Source of Organisms in the Post‐prostatectomy Bacteriuria of Patients with Pre‐operative Sterile Urine

Abstract

Summary Ninety patients undergoing prostatectomy for benign prostatic hyperplasia (BPH) with sterile urine pre‐operatively were prospectively studied for post‐prostatectomy bacteriuria; 26 of 90 patients (29%) developed bacteriuria (18 of 64 after transurethral resection (TUR) and 8 of 26 after open prostatectomy), of whom 15 had pre‐operative indwelling urethral catheters. The correlation of bacteriuria with several factors was studied, namely the presence of a histological inflammatory reaction within the prostatic adenoma, prostatic tissue culture, intraoperative outgoing irrigation fluid culture, intra‐operative blood culture and post‐operative external meatal swab culture. The only significant correlation was between bacteriuria and meatal cultures. It was concluded that post‐prostatectomy bacteriuria is probably caused by post‐operative ascending infection along urethral catheters. There was not enough evidence to ascribe bacteriuria to pre‐existing septic foci within the adenoma. Intra‐operative contamination and infection from distant foci were also unlikely causes.