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Comparison of local povidone-iodine antisepsis with parenteral antibacterial prophylaxis for prevention of infective complications of TURP: a prospective randomized controlled study.
- Source :
-
European urology [Eur Urol] 2002 Mar; Vol. 41 (3), pp. 250-6. - Publication Year :
- 2002
-
Abstract
- Objective: To determine whether antisepsis with povidone-iodine solution applied at the external urethral meatus confers protection against infective complications following transurethral resection of the prostate (TURP) and compare that with antibacterial prophylaxis.<br />Methods: A total of 167 patients with sterile urine undergoing TURP for benign prostatic hyperplasia (BPH) were prospectively randomized into three groups. Group A, had gauze soaked in saline applied at the urethral meatus (control group). In group B, the gauze was soaked in povidone-iodine instead of saline and group C had a single 1 g i.v. injection of cephradine at induction of anaesthesia with no treatment for the meatus. Bacteraemia, post-operative bacteriuria and other infective complications were compared in the three groups. Associations of bacteriuria at catheter removal and intra-operative bacteraemia with infective complications and with long term bacteriuria were also studied.<br />Results: Bacteriuria rate at catheter removal was not significantly different in the three groups. However, intraoperative bacteraemia and bacterial growth at the external urethral meatus was significantly lower in group C. Bacteriuria at catheter removal was significantly associated with bacterial growth at the meatus but not with long term bacteriuria at 3 months. Bacteriuria at catheter removal could not accurately predict infective complications.<br />Conclusion: Post-TURP bacteriuria appears to be preceded by bacterial growth at the external urethral meatus. Antisepsis with povidone-iodine solution application at the meatus does not confer adequate protection against meatal bacterial growth as that obtained by prophylactic antibacterials. Nonetheless, neither antibacterial prophylaxis nor local antisepsis could reduce bacteriuria rate in this study.
- Subjects :
- Administration, Topical
Aged
Anti-Bacterial Agents administration & dosage
Anti-Infective Agents, Local administration & dosage
Cephradine administration & dosage
Escherichia coli Infections prevention & control
Humans
Male
Povidone-Iodine administration & dosage
Prospective Studies
Urinary Catheterization
Anti-Bacterial Agents therapeutic use
Anti-Infective Agents, Local therapeutic use
Antibiotic Prophylaxis
Bacteriuria prevention & control
Cephradine therapeutic use
Povidone-Iodine therapeutic use
Surgical Wound Infection prevention & control
Transurethral Resection of Prostate
Subjects
Details
- Language :
- English
- ISSN :
- 0302-2838
- Volume :
- 41
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- European urology
- Publication Type :
- Academic Journal
- Accession number :
- 12180224
- Full Text :
- https://doi.org/10.1016/s0302-2838(02)00013-1