ANTIBIOTIC PROPHYLAXIS AT TIME OF CATHETER REMOVAL FOLLOWING LAPAROSCOPIC RADICAL PROSTATECTOMY: A PROSPECTIVE RANDOMIZED STUDY

Objective: To assess the influence of antibiotic prophylaxis on the bacteriuria as well as leukocyturia after catheter removal following laparoscopic radical prostatectomy (LRP). Methods: This was a prospective randomized study in which 160 patients undergoing LRP were randomized either for receiving 7-day antibiotic prophylaxis starting at urinary catheter removal, or not. A urine specimen was collected for urinalysis on the removal of catheter, and at 1, 4 and 8 weeks after operation. Urine was collected for culture on the removal of catheter and 4 weeks later. The bacteriuria and leukocyturia occurring within 8 weeks after catheter removal were compared between groups. Results: Eighty patients received antibiotic prophylaxis. The overall incidence of bacteriuria after catheter removal was 18.1% (291160), but there was no significant difference between two groups (with and without prophylaxis, 16180 and 13180, respectively; P=0.538). However, antibiotic resistance occurred more frequently in the antibiotic prophylaxis group (P=0.025). Moreover, the postoperative urine leukocyte counts were comparable between 2 groups at different time points (P>0.05). Conclusion: Bacteriuria and leukocyturia should be safely managed with culture-specific antibiotic prophylaxis and carefully monitored after catheter removal following LRP. Antibiotic prophylaxis has no influence on the urine leukocyte counts after LRP.