The Risk of Inducing Bacteriuria in Urodynamic and Uroradiological Studies of Men with Prostatism

Abstract

The risk of inducing bacteriuria during urodynamic and uroradiological studies of men with prostatism was studied. Of 107 consecutive patients entering the study, 68 patients without indwelling urethral catheter completed the following investigative program: 1) Urodynamic studies including uroflowmetry, medium fill water cystometry and simultaneous pressure-flow studies with sphincter electromyography and 2) Uroradiological studies consisting of voiding cysto-urethrography with simultaneous recording of urine flow-rate and intravesical pressure. The whole work-up was completed within 6 days and comprised 2 urethral catheterisations. A catheterurine culture was obtained at the first catheterisation, and a mid-stream specimen was collected 1 week after the initial catheterisation. Careful aseptic techniques were employed at the 2 catheterisations. Bacteriuria (>10⁵ colony forming units/ml urine) was found in 9% of the patients at the initial catheterisation. Following the urodynamic and uroradiological studies bacteriuria occurred in 4 (6%) of the patients with initially sterile urine (95% confidence limits: 2-14%). The urethral flora was studied and the pathogenesis of iatrogenic bladder infection in prostatism is discussed along with prophylactic measures. The risk of inducing urinary tract infection in urodynamic and uroradiological studies of men with prostatism is acceptably low provided these studies are performed on clear indications. Sterile techniques for catheterisation are mandatory and a follow-up mid-stream urine culture should be performed 1 week after the examinations.