[Urinary bacteriologic study prior to endoscopic urologic surgery]. / Estudio bacteriológico de la orina previa a la cirugía urológica endoscópica.

OBJECTIVE: The objectives of this study are to know the incidence of preoperative bacteriuria in patients undergoing endoscopic urologic surgery, to analyze the most frequent microorganisms appearing in the cultures and their resistance to antibiotics in order to select the most appropriate prophylactic one for our population, and to determine the risk factors related to postoperative bacteriuria or sepsis of urologic origin. MATERIAL AND METHODS: 449 patients undergoing endoscopic urologic surgery were included in the study. Urinary samples were collected for culture prior to prophylactic antibiotic administration and again a week after bladder catheter removal once the antibiotic treatment was finished. Variables related to an increase in infectious complications were analyzed. Special attention was paid to postoperatory incidences, mainly those of infectious nature. RESULTS: Preoperative bacteriuria was found in 66 out of 428 patients (15.4%). It was found to be related to age, sex, previous infection episodes, diabetes mellitus, indwelling catheter and to the pathology for which operation was indicated. The most frequently found microorganism was Escherichia Coli. Resistance to prophylactic antibiotic was found in 37.9% of patients with preoperatory bacteriuria. Postoperatory bacteriuria, observed in 22.0% of the patients was exclusively related to preoperatory bacteriuria. 2.9% of patients showed sepsis of urinary origin criteria during hospital staying, and it was found to be exclusively related to length of surgery and neither to preoperatory bacteriuria nor to indwelling catheter time or the "inappropriate" prophylactic antibiotic use in these cases. CONCLUSIONS: A good part of patients who underwent endoscopic surgery showed preoperatory bacteriuria, responsible for postoperative bacteriuria in less than 25% of the cases. The length of surgery seemed to be the only related cause whit sepsis of urinary origin.

Estudio bacteriológico de la orina previa a la cirugía urológica endoscópica / Urinary bacteriologic study prior to endoscopic urologic surgery

Objetivo: Los objetivos de este estudio son conocer la incidencia de bacteriuria preoperatoria en pacientes que van a ser sometidos a intervenciones urológicas por vía endoscópica, analizar los microorganismos más frecuentes que aparecen en los cultivos y sus resistencias a los antibióticos, para así seleccionar el antibiótico profiláctico más apropiado para nuestra población y determinar qué factores de riesgo están relacionados con la aparición de bacteriuria o sepsis urinaria en el postoperatorio. Material y Método: Se incluyeron en el estudio a 449 pacientes a los que se les iba a someter a cirugía urológica endoscópica. Se recogieron muestras de orina para su cultivo antes de la administración del antibiótico profiláctico y se volvieron a tomara la semana de retirar la sonda vesical, ya sin tratamiento antibiótico. Se analizaron las variables que podían estar relacionadas con la mayor incidencia de complicaciones infecciosas. Se prestó especial atención a las incidencias del postoperatorio, y sobre todo, a las de naturaleza infecciosa. Resultados: Se detectó bacteriuria preoperatoria en 66 de 428 pacientes (15,4%). Esta se asoció a la edad, el sexo, la historia de infecciones previas, la existencia de diabetes mellitus, la presencia de sonda vesical y a la patología que indicaba la intervención quirúrgica. El tipo de microorganismo más frecuente fue Escherichia coli (43,1%). En el 37,9% de los pacientes con bacteriuria preoperatoria el microorganismo fue resistente al antibiótico utilizado profilácticamente para la intervención quirúrgica. Apareció bacteriuria postoperatoria en el 22% de los pacientes, lo que se asoció únicamente a la presencia de bacteriuria preoperatoria. El 2,9% de los pacientes tuvieron criterios de sepsis de origen urinario durante la estancia hospitalaria. La sepsis se asoció únicamente a la duración de la cirugía y no a la presencia de bacteriuria preoperatoria, ni con los días de permanencia de la sonda, y ni a la utilización, en estos casos, de un antibiótico profiláctico “no apropiado”. Conclusión: Una parte importante de los pacientes sometidos a cirugía endoscópica presentan bacteriuria preoperatoria, aunque fue responsable de la bacteriuria posoperatoria en menos del 25% de los casos. La duración de la cirugía parece ser la única causa relacionada con la sepsis de origen urinario (AU)

Objective: The objectives of this study are to know the incidence of preoperative bacteriuria in patients undergoing endoscopic urologic surgery, to analyze the most frequent microorganisms appearing in the cultures and their resistance to antibiotics in order to select the most appropriate prophylactic one for our population, and to determine the risk factors related to postoperative bacteriuria or sepsis of urologic origin. Material and Methods: 449 patients undergoing endoscopic urologic surgery were included in the study. Urinary samples were collected for culture prior to prophylactic antibiotic administration and again a week after bladder catheter removal once the antibiotic treatment was finished. Variables related to an increase in infectious complications were analyzed. Special attention was paid to postoperatory incidences, mainly those of infectious nature. Results: Preoperative bacteriuria was found in 66 out of 428 patients (15.4%). It was found to be related to age, sex, previous infection episodes, diabetes mellitus, indwelling catheter and to the pathology for which operation was indicated. The most frequently found microorganism was Escherichia Coli. Resistance to prophylactic antibiotic was found in 37.9% of patients with preoperatory bacteriuria. Postoperatory bacteriuria, observed in 22.0% of the patients was exclusively related to preoperatory bacteriuria. 2.9% of patients showed sepsis of urinary origin criteria during hospital staying, and it was found to be exclusively related to length of surgery and neither to preoperatory bacteriuria nor to indwelling catheter time or the “inappropriate” prophylactic antibiotic use in these cases. Conclusions: A good part of patients who underwent endoscopic surgery showed preoperatory bacteriuria, responsible for postoperative bacteriuria in less than 25% of the cases. The length of surgery seemed to be the only related cause whit sepsis of urinary origin (AU)

Sobre la necesidad del rasurado de la región púbica en los pacientes que van a ser sometidos a cirugía urológica endoscópica / On the need of pubic region shaving in patients undergoing endoscopic urologic surgery

OBJETIVO: El objetivo del estudio es determinar, mediante un ensayo clínico aleatorio controlado, si se produce algún aumento en el número de bacteriurias postoperatorias de un grupo de pacientes sometidos a cirugía urológica endoscópica, a los que no se rasura la región púbica (práctica inhabitual en la preparación quirúrgica actual). MATERIAL Y MÉTODO: El estudio se realizó distribuyendo a los pacientes que iban a ser intervenidos mediante cirugía urológica endoscópica de forma aleatoria en dos grupos. A un grupo se le rasuró la región púbica, según las técnicas habituales, mientras que al otro grupo no se le rasuró dicha región; el resto de la preparación fue igual para ambos grupos. Se recogieron muestras de orina para su cultivo antes de la administración del antibiótico profiláctico y se volvieron a tomar a la semana de retirar la sonda vesical, ya sin tratamiento antibiótico. Se prestó especial atención a las incidencias del postoperatorio, sobre todo, a las de naturaleza infecciosa. RESULTADOS: Se incluyeron un total de 449 pacientes, de los cuales 149 fueron retirados del estudio por diferentes causas. De estos, 149 fueron rasurados y 151 no lo fueron. En el grupo de pacientes no rasurados se observó una tasa de bacteriuria postoperatoria del 19,5%, mientras que en el otro grupo fue del 16,6%, no observándose diferencias estadísticamente significativas. CONCLUSIÓN: La conclusión a la que se llegó es que no se produce un aumento de bacteriurias postoperatorias en los pacientes sometidos a cirugía urológica endoscópica, a los que no se les rasura la región púbica, en comparación con el grupo de pacientes que son rasurados con cuchillas desechables

OBJECTIVE: The objective of this study is to assess the effects of preoperative shaving of the pubic region on postoperative bacteriuria after endoscopic urological surgery. MATERIALS AND METHOD: The study was carried out distributing the patients undergoing endoscopic urological surgery in a controlled randomized way in two groups. In a group the pubic region was shaved, according to the habitual techniques, while the other group was not shaved; the rest of the preparation was the same for both groups. Urine samples were collected for their culture before the administration of the prophylactic antibiotic and a week after the removal of the Foley catheter, yet without antibiotic treatment. Special attention was paid to the postoperative incidences, mainly, those of infectious nature. RESULTS: They were included a total of 449 patients, of which 149 were removed from the study by different causes. Of these, 149 were shaved and 151 were not it. In the group of unshaved patients a 19,5% of postoperative bacteriurias was observed, while in the other group it was of 16,6%. Differences in both groups were not statistically significant. CONCLUSIONS: We conclude that there is no an increase of postoperative bacteriurias in the unshaved patients undergoing endoscopic urological surgery, compared with the group of patients shaved with disposable bladders

[On the need of pubic region shaving in patients undergoing endoscopic urologic surgery]. / Sobre la necesidad del rasurado de la región púbica en los pacientes que van a ser sometidos a cirugía urológica endoscópica.

OBJECTIVE: The objective of this study is to assess the effects of preoperative shaving of the pubic region on post-operative bacteriuria after endoscopic urological surgery. MATERIALS AND METHOD: The study was carried out distributing the patients undergoing endoscopic urological surgery in a controlled randomized way in two groups. In a group the pubic region was shaved, according to the habitual techniques, while the other group was not shaved; the rest of the preparation was the same for both groups. Urine samples were collected for their culture before the administration of the prophylactic antibiotic and a week after the removal of the Foley catheter, yet without antibiotic treatment. Special attention was paid to the postoperative incidences, mainly, those of infectious nature. RESULTS: They were included a total of 449 patients, of which 149 were removed from the study by different causes. Of these, 149 were shaved and 151 were not it. In the group of unshaved patients a 19.5% of postoperative bacteriurias was observed, while in the other group it was of 16.6%. Differences in both groups were not statistically significant. CONCLUSIONS: We conclude that there is no an increase of postoperative bacteriurias in the unshaved patients undergoing endoscopic urological surgery, compared with the group of patients shaved with disposable bladders.

[Treatment of pelvis fungus ball with ureteral catheterization, fluconazole, and urine alkalinization]. / Tratamiento del fungus ball piélico con cateterismo ureteral, fluconazol y alcalinización de la orina.

Fungal concretions known as "fungus ball" may be the cause of ureteral obstruction, normally presenting as pain in the renal cavity. This paper presents one case treated with ureteral catheterism, fluconazol and urine alkalinization.