The incidence and risk factors of male urinary tract infection following invasive urodynamic investigation

Abstract

To assess the prevalence of male urinary tract infection (UTI) after invasive urodynamic studies and to determinate the risk factors by evaluating the clinical characteristics and urodynamic parameters of patients. Six hundred and seventy-one consecutive men were recruited. All patients accepted urine routine tests and(or)urine culture three times. The first culture and routine tests were carried out in the 2 to 4 weeks before urodynamic studies by using clean-catch midstream urine (MSU) or catheter urine specimen. The second urine routine test was carried out at the start of examinations and the last urine culture were carried out in 48-72 hours after the investigations. Male patients with negative results (leucocytes <15 cells/ul and <10(5) colony-forming units per milliliter [cfu/ml]) in 1(st) and 2(nd) time received a standard urodynamic investigation. The investigations of the remaining patients were postponed until the urinary tract infection had been treated. The prevalence of urinary tract infection before urodynamic investigation (with positive results in 1(st) and 2(nd) urine test) was 7.3%, and the prevalence after the investigation in patients without UTI before examination was 10.3%. Bladder outlet obstruction (BOO), age ≥ 65 years, and diabetes were the risk factors for UTI after urodynamic investigation. The most common uropathogens in the urinary tract infections after the urodynamic investigation were Escherichia coli (53.1%, 34/64) and Enterococcus faecalis (17.2%, 11/64). Despite a stringent standard operation protocol, the prevalence of UTI in male patients caused by urodynamic examination is about 10%. For the high-risk patients with BOO, older age, and diabetes, prophylactic antibiotic treatment before or after procedure may be necessary.