Are Urine Cultures Necessary Prior to Urologic Prosthetic Surgery?

Nicholas L. Kavoussi, Boyd R. Viers, Travis J. Pagilara, Jordan A. Siegel, Matthias D. Hofer, Billy Cordon, Nabeel Shakir, Jeremy Scott, Allen F. Morey

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Introduction: A preoperative negative urine culture is generally advised before implantation of urologic prosthetics to prevent device infection. However, a review of the medical literature indicates sparse evidence to support this practice. Aim: To describe outcomes for patients undergoing prosthetic implantation without preoperative urine cultures. Methods: The cases of men undergoing artificial urinary sphincter (AUS) and/or inflatable penile prosthesis (IPP) placement at a tertiary care center from 2007 through 2015 were reviewed. Of 713 devices implanted in 681 patients (337 AUSs in 314 patients, 376 IPPs in 367), 259 cases without preoperative urine cultures were analyzed (41%). Patients received standard perioperative antibiotics. Main Outcome Measures: Device infection was diagnosed clinically. Average follow-up was 15 months. Results: Device infection occurred in 4 of 259 patients (1.5%) with no difference noted in infection rate between device groups (AUS = 3 of 174 [2%]; IPP = 1 of 85 [1%]; P = .99); this rate appears to be consistent with the infection rate of numerous other published prosthetic series. Common skin organisms were implicated as the infectious agents in half the infected devices. Only one patient (0.4%) developed an Escherichia coli infection. Conclusion: This study suggests that prosthetic urologic surgery can be safely performed without preoperative urine cultures. Kavoussi NL, Viers BR, Pagilara TL, et al. Are Urine Cultures Necessary Prior to Urologic Prosthetic Surgery? Sex Med Rev 2017;X:XXX-XXX.

Original languageEnglish (US)
JournalSexual Medicine Reviews
DOIs
StateAccepted/In press - Jan 4 2017

Fingerprint

Urine
Equipment and Supplies
Artificial Urinary Sphincter
Penile Prosthesis
Infection
Escherichia coli Infections
Tertiary Care Centers
Outcome Assessment (Health Care)
Anti-Bacterial Agents
Skin

Keywords

  • Artificial Urinary Sphincter
  • Penile Prosthesis

ASJC Scopus subject areas

  • Reproductive Medicine
  • Dermatology
  • Obstetrics and Gynecology
  • Urology

Cite this

Kavoussi, N. L., Viers, B. R., Pagilara, T. J., Siegel, J. A., Hofer, M. D., Cordon, B., ... Morey, A. F. (Accepted/In press). Are Urine Cultures Necessary Prior to Urologic Prosthetic Surgery? Sexual Medicine Reviews. https://doi.org/10.1016/j.sxmr.2017.03.007

Are Urine Cultures Necessary Prior to Urologic Prosthetic Surgery? / Kavoussi, Nicholas L.; Viers, Boyd R.; Pagilara, Travis J.; Siegel, Jordan A.; Hofer, Matthias D.; Cordon, Billy; Shakir, Nabeel; Scott, Jeremy; Morey, Allen F.

In: Sexual Medicine Reviews, 04.01.2017.

Research output: Contribution to journalArticle

Kavoussi, NL, Viers, BR, Pagilara, TJ, Siegel, JA, Hofer, MD, Cordon, B, Shakir, N, Scott, J & Morey, AF 2017, 'Are Urine Cultures Necessary Prior to Urologic Prosthetic Surgery?', Sexual Medicine Reviews. https://doi.org/10.1016/j.sxmr.2017.03.007
Kavoussi NL, Viers BR, Pagilara TJ, Siegel JA, Hofer MD, Cordon B et al. Are Urine Cultures Necessary Prior to Urologic Prosthetic Surgery? Sexual Medicine Reviews. 2017 Jan 4. https://doi.org/10.1016/j.sxmr.2017.03.007
Kavoussi, Nicholas L. ; Viers, Boyd R. ; Pagilara, Travis J. ; Siegel, Jordan A. ; Hofer, Matthias D. ; Cordon, Billy ; Shakir, Nabeel ; Scott, Jeremy ; Morey, Allen F. / Are Urine Cultures Necessary Prior to Urologic Prosthetic Surgery?. In: Sexual Medicine Reviews. 2017.
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abstract = "Introduction: A preoperative negative urine culture is generally advised before implantation of urologic prosthetics to prevent device infection. However, a review of the medical literature indicates sparse evidence to support this practice. Aim: To describe outcomes for patients undergoing prosthetic implantation without preoperative urine cultures. Methods: The cases of men undergoing artificial urinary sphincter (AUS) and/or inflatable penile prosthesis (IPP) placement at a tertiary care center from 2007 through 2015 were reviewed. Of 713 devices implanted in 681 patients (337 AUSs in 314 patients, 376 IPPs in 367), 259 cases without preoperative urine cultures were analyzed (41{\%}). Patients received standard perioperative antibiotics. Main Outcome Measures: Device infection was diagnosed clinically. Average follow-up was 15 months. Results: Device infection occurred in 4 of 259 patients (1.5{\%}) with no difference noted in infection rate between device groups (AUS = 3 of 174 [2{\%}]; IPP = 1 of 85 [1{\%}]; P = .99); this rate appears to be consistent with the infection rate of numerous other published prosthetic series. Common skin organisms were implicated as the infectious agents in half the infected devices. Only one patient (0.4{\%}) developed an Escherichia coli infection. Conclusion: This study suggests that prosthetic urologic surgery can be safely performed without preoperative urine cultures. Kavoussi NL, Viers BR, Pagilara TL, et al. Are Urine Cultures Necessary Prior to Urologic Prosthetic Surgery? Sex Med Rev 2017;X:XXX-XXX.",
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AB - Introduction: A preoperative negative urine culture is generally advised before implantation of urologic prosthetics to prevent device infection. However, a review of the medical literature indicates sparse evidence to support this practice. Aim: To describe outcomes for patients undergoing prosthetic implantation without preoperative urine cultures. Methods: The cases of men undergoing artificial urinary sphincter (AUS) and/or inflatable penile prosthesis (IPP) placement at a tertiary care center from 2007 through 2015 were reviewed. Of 713 devices implanted in 681 patients (337 AUSs in 314 patients, 376 IPPs in 367), 259 cases without preoperative urine cultures were analyzed (41%). Patients received standard perioperative antibiotics. Main Outcome Measures: Device infection was diagnosed clinically. Average follow-up was 15 months. Results: Device infection occurred in 4 of 259 patients (1.5%) with no difference noted in infection rate between device groups (AUS = 3 of 174 [2%]; IPP = 1 of 85 [1%]; P = .99); this rate appears to be consistent with the infection rate of numerous other published prosthetic series. Common skin organisms were implicated as the infectious agents in half the infected devices. Only one patient (0.4%) developed an Escherichia coli infection. Conclusion: This study suggests that prosthetic urologic surgery can be safely performed without preoperative urine cultures. Kavoussi NL, Viers BR, Pagilara TL, et al. Are Urine Cultures Necessary Prior to Urologic Prosthetic Surgery? Sex Med Rev 2017;X:XXX-XXX.

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