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.