ANTIBIOTIC PROPHYLAXIS ON THE TIME OF CATHETER REMOVAL FOLLOWING LAPAROSCOPIC RADICAL PROSTATECTOMY

Objective. To assess the interaction between antibiotic prophylaxis and bacteriuria, leukocyturia after catheter removal following laparoscopic radical prostatectomy (LRP).

Patients and methods. A prospective randmized study enrolled 180 patients undergoing LRP, who were randomized either for receiving 7 days of prophylactic antibiotics starting at urinary catheter removal, or not. A urine specimen was collected for urinalysis on removal of the catheter, 1, 4 and 8 weeks after operation. Another urine specimen was collected for urine culture on removal of the catheter and 4 weeks later. The groups were compared for the bacteriuria, leukocyturia occuring within 8 weeks after catheter removal.

Results. Antibiotic prophylaxis was given to 80 of 145 LRP patients (55.17%), while the remainnig 65 patients did not receive antibiotic prophylaxis. The total incidence of bacteriuria after catheter removal following LRP was 20% (29/145), which was showed no significantly differences between the two groups (with or without prophylaxis, 16/80, 13/65, P>0.05). However, antibiotic resistance occurred most frequently in the antibiotic prophylaxis group and was significant difference between 2 groups (P=0.025). Moreover, postoperative change in urine leukocyte counts were not significantly different between the 2 groups (P>0.05).

Conclusion. Bacteriuria and luekocyturia should be safely managed with culture-specific antibiotic prophylaxis and careful monitoring after catheter removal following LRP. There is no detectable significant benefit in using antibiotic prophylaxis to reduce the urine leukocyte counts after LRP.