Subject(s)
Diabetes Mellitus, Type 2/complications , Kidney Papillary Necrosis/surgery , Ureteroscopy/methods , Diabetic Nephropathies/diagnostic imaging , Diabetic Nephropathies/etiology , Diabetic Nephropathies/pathology , Diabetic Nephropathies/surgery , Female , Humans , Hydronephrosis/diagnostic imaging , Hydronephrosis/etiology , Hydronephrosis/surgery , Kidney Papillary Necrosis/diagnostic imaging , Kidney Papillary Necrosis/etiology , Kidney Papillary Necrosis/pathology , Middle Aged , Tomography, X-Ray Computed , UrographyABSTRACT
INTRODUCTION: We sought to investigate three different antibiotic protocols in transurethral resection of a bladder tumour (TURBT), and the possible infectious risk factors of this surgery. METHODS: We conducted a non-randomized, prospective study, gathering cases of patients in whom TURBT had been performed. The sample was divided into three groups based on those who received antibiotics as: a single preoperative dose (Group A); a preoperative dose, plus a long protocol during the hospitalization (Group B); a preoperative dose, plus a long protocol during the hospitalization, plus five days at home (Group C). Intra- and postoperative data that could be relevant to infections was gathered. RESULTS: A total of 219 patients were included. In the multivariate analysis, it was observed that the patients in Group A were more prone to re-hospitalization due to fever than were those from Group C (odds ratio [OR] 11.13; p=0.03). Furthermore, the cases with tumour necrosis and those who entered surgery with a urinary catheter were more prone to have a temperature above 37.5°C (OR6.74; p=0.02 and OR6.4; p=0.04, respectively), as well as have an increased risk per every additional tumour in the cystoscopy (OR 1.32; p=0.01). Those who received mitomycin had a lower chance of a positive urine culture (OR 0.29; p=0.01), contrary to those patients with over two days of hospitalization (OR 4.11; p<0.01) and those who entered surgery with a urinary catheter (OR 12.35; p=0.02). CONCLUSIONS: Those patients that only received a single dose of antibiotic before TURBT may have an increased risk of re-hospitalization due to fever in comparison to those who received prolonged antibiotic protocols. In addition, there are perioperative factors in this surgery that predict the risk of infectious complications.