843 Asymptomatic Bacteriuria at Flexible Cystoscopy- Can We Reduce Cancellations?

Abstract

Abstract Introduction At our trust patients with nitrite positive urinalysis attending for flexible cystoscopy (FC) are rescheduled, placing a heavy burden on over stretched NHS resources. It is accepted that asymptomatic bacteriuria (AB) affects up to 20% of patients over 70. Catheters, stents, and recent antibiotics for a urinary tract infection also significantly increases this risk. Recent evidence suggests that proceeding to cystoscopy in patients with AB is safe, and we evaluated our cohort of patients to identify what proportion of our patients it would be safe to proceed in. Method We reviewed all outpatient FC over a four-month period. We interrogated cancelled FC procedures where patients were cancelled for a nitrite positive urinalysis. Information recorded included result of urine culture, whether an antibiotic was prescribed and risk factors for AB. Results 1241 FC were performed. Mean age was 78.4. In a total, 61 patients (4.9%) were postponed due to nitrite positive urinalysis. 58 (95.1%) patients were asymptomatic, of which 31 (53.4%) demonstrated bacterial growth on culture. Risk factors for AB included catheters (n = 14), a ureteric stent (n = 2), regular antibiotics for recurrent UTIs (n = 27). Conclusions Data collected confirms our cohort is at high risk of AB. Based on the findings from Trail et al, we propose that proceeding to FC in patients with asymptomatic bacteriuria is safe and intend to implement this change in our department. This will reduce demand on FC waiting lists and improve time to diagnosis.