Risk Factors Predicting Fever After Trans-Urethral Prostatectomy
There are several risk factors for the occurrence of febrile events after Trans-Urethral Prostatectomy- TURP. Our aim was to examine the risk factors for postoperative fever in patients undergoing TURP at our institution.
A total of 177 patients underwent TURP during 1/2016-8/2017. Data collected included: postoperative fever (>=38 degrees Celsius), presence of a permanent catheter, antibiotic treatment, preoperative urine culture, diabetes, procedure combined with bladder stone treatment and prostate size.
All patients received antibiotic prophylaxis prior to the procedure. 83 patients who had a negative urine culture were empirically treated (IV Amikacin + IV Ampicillin), 94 with positive urine culture were treated according to bacteria sensitivity profile. One patient developed fever in the group of patients with negative culture, compared to 8 in the group undergoing surgery with positive urine culture (p=0.0375). No patient developed a septic shock. Procedures combined with cystolithotripsy (p=1.00), indwelling urethral catheter (p=0.16230) and diabetes (p=0.4775) did not increase the risk of fever after surgery. Sixteen patients received antibiotics a week prior to surgery, none of them developed fever after surgery. To our surprise, a smaller prostate size increased the risk of a postoperative febrile event (<45cc; p= 0.009).</p>
Positive urinary culture prior to TURP is a frequent event. In our study, although positive urinary culture increased the risk of post TURP febrile events, none of these events caused significant morbidity.