Post TURP Pyuria for Evaluation and Management

Abstract

Transurethral resection of the prostate is one of the most widely performed urologic procedures. Although there is a variety of new techniques in the surgical management of BPH, TURP remains the gold standard by which all other measures are judged. Pyuria following TURP constitutes an important factor that can greatly affect the out come of surgery and adds to the morbidity of the patient and the cost of the procedure as well as the length of hospital study. Therefore, we conducted this prospective study for 35 selected patients undergoing TURP at Faysal Soad El Fleeg Hospital, Desouq, Kafr Elsheikh, and studied the incidence, duration of pyuria as well as the risk factors associated with pyuria after TURP. The selection criteria of patients depended mainly on the documentation of preoperative sterility of urine proved by preoperative urine culture and urine analysis. Patients were given antibiotic prophylaxis in the form of ceftriaxone 1gm. I.V. one hour before the procedure and continued postoperatively. Twice daily until removal of catheter, then the patient would continue in oral Tinifloxacin. Twice daily for 7 days. We found it was unnecessary to change the antibacterial agent even when pyuria continues. Regional anaesthesia was given and the procedure was performed in the classic Nesbit technique, urethral catheter with continuous irrigation system fixed. Several postoperative parameters were monitored. Urine analysis, culture were taken after 1-week, 1-month and 3-months. The incidences of postoperative pyuria were 100.0%, 51.4%, 20% at 1-week, 1-month and 3-months. The incidences of dysuria at 1-week, 1-month and 3-months after TURP were 45.7%, 34.2% and 8.5% respectively. Marked postoperative improvement were seen in flow rates, residual urine, IPSS and QOL at 3-months after TURP compared to preoperative values. The age of patient had a statistically significant impact on