You have accessJournal of UrologyCME1 May 2022PD06-07 REAL-WORLD URINARY TRACT INFECTION RATES AND ANTIBIOTIC PRACTICE WITH URETHRAL INJECTION OF POLYACRYLAMIDE HYDROGEL (BULKAMID®) Shreeya Popat, Justina Tam, Hannah Koenig, Alvaro Lucioni, Kathleen Kobashi, and Una Lee Shreeya PopatShreeya Popat More articles by this author , Justina TamJustina Tam More articles by this author , Hannah KoenigHannah Koenig More articles by this author , Alvaro LucioniAlvaro Lucioni More articles by this author , Kathleen KobashiKathleen Kobashi More articles by this author , and Una LeeUna Lee More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002525.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Polyacrylamide hydrogel (PAHG) (Bulkamid®) is a transurethral bulking agent that has demonstrated safety, efficacy, and durability in the treatment of stress urinary incontinence in women. Initial clinical trials report a post-procedure urinary tract infection (UTI) rate of 3.5%. While manufacturer information recommends pre-procedure antibiotics, the American Urological Association best practice statement is uncertain about antibiotic prophylaxis, and real-world practice is varied. Therefore, we report a single institution’s experience with UTI following PAHG urethral bulking. METHODS: Charts of patients who underwent PAHG urethral bulking from May 2020 to March 2021 were retrospectively reviewed. Demographic characteristics were collected, along with pre-procedure urinalyses (UA) and if prophylactic antibiotics were administered. In addition, charts were reviewed for post-procedure UTI. UTI was defined by prescription of antibiotics for UTI symptoms within 14 days of the procedure. Statistical analysis examining significant differences between groups that did and did not have post-procedure UTI was performed using Fisher’s exact test. RESULTS: During the study period, 103 women underwent PAHG for urethral bulking by 3 FPMRS surgeons at a single institution. 72 (69.9%) received pre-procedure prophylactic antibiotics. On pre-operative UA, 93 (88.3%) were positive for leukocyte esterase, 23 (22.3%) for blood, and only 1 was positive for nitrites. Only 3 of these samples resulted in a positive urine culture. Eleven of the 103 (10.7%) patients were prescribed antibiotics within 14 days of PAHG urethral bulking for a UTI. Of the 3 patients with incidentally positive urine cultures prior to the procedure, only one developed UTI symptoms and was treated with antibiotics. Presence of blood or nitrites on pre-procedure UA was not significantly related with post-procedure UTI. However, leukocyte esterase positivity was significantly related with post-procedure UTI (p = 0.03). Limitations include that this was a retrospective study and therefore not powered to determine UTI rate. CONCLUSIONS: In this cohort of real-world practice of PAHG urethral bulking, the incidence of UTI was 10.7%. Administration of prophylactic antibiotics varied and was not associated with lower rates of post-procedure UTIs. Although leukocyte esterase on pre-procedure urinalyses correlated with post-procedure UTIs on this initial analysis, more studies are needed to meaningfully guide clinical practice. Source of Funding: N/A © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e95 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Shreeya Popat More articles by this author Justina Tam More articles by this author Hannah Koenig More articles by this author Alvaro Lucioni More articles by this author Kathleen Kobashi More articles by this author Una Lee More articles by this author Expand All Advertisement PDF DownloadLoading ...