Surgery for benign prostatic hyperplasia (BPH) has undergone technical innovations in recent years. The aim of this study was to evaluate the impact of surgical technique and the risk factors of postoperative infections in patients treated surgically for BPH.
TOCUS study was a multicenter, retrospective, nationwide study that included all patients screened for ABU prior urologic surgery. This study included all patients treated surgically for BPH from January 2016 to April 2021. The primary endpoint was Postoperative Infections (PI) occurrence (surgical site infection or febrile urinary tract infection or urosepsis) occurring within 30 days after surgery. Our study was registered by the “Commission Nationale de l’Informatique et des Libertés” under the number MR 1516140520. Descriptive analyses and Odds Ratio estimates by logistic regression were performed with StatView 17.5 software.
In total, 380 patients were included with a PI rate of 6.7% (Table 1). The median age at surgery was 71 years (34–94). Median operative time was 71 minutes (10-460). The majority of patients received endoscopic treatment and 5.5% had simple prostatectomy (Table 1). There was no significant difference between open surgery and endoscopy in terms of PI (p = 0.80). The risk factors for PI were significant leukocyturia (OR 7.54; 95% CI 2.13 – 26.71; p = 0.007), positive preoperative Urine Culture (UC) (OR 26.01; 95% CI 3.24 – 208.91; p = 0.002), polymicrobial UC (OR 18.35; 95% CI 1.6 – 210.29; p = 0.02) and indwelling urinary catheter (OR 2.91; 95% CI 1.09 – 7.77; p=0.03). On the other hand, the type of surgery was not predisposing factors for PI (Table 2).
This study confirms that PI are independent of BPH surgical technique but are more related to prophylactic measures and characteristics of preoperative UC.