Preoperative and Postoperative Complications in Men with Benign Prostate Enlargement Undergoing Open Retropubic Prostatectomy and the Choice of Antibiotics: A Single Surgeon Experience Urinary tract infection and benign prostate enlargement

Abstract

Objective: To determine the preoperative and postoperative complications, organisms, and appropriate choice of antibiotics in men with benign prostatic hyperplasia complicated by acute urinary retention who required prostatectomy. Materials and Methods: The data of 65 patients who underwent open retropubic prostatectomy was reviewed. They were divided into two groups those with urinary tract infection and those without it. Intervention was urethral catheterization, antibiotics and open retropubic prostatectomy. The main outcome were urinary tract infection and choice of antibiotics. Results: The number of patients per group, mean age, mean prostate volumes were 36 and 29, 69.7years and 70.7 years, 144ml and 143ml, respectively. Of 267 men with BPH, 65(24.3%) had surgery. Preoperative urinary tract infections were 55.4% while the preoperative and postoperative complications were in group I (70.8% and 13.8%) and in group II (24.6% and 9.2%) respectively. Overall persistent postoperative UTI was 4.6%. The commonest organisms isolated in those with acute urinary retention were E. coli 41.6%, klebsiella species 27.8% and Pseudomonas aeruginosa 13.9%. Majority of the organisms isolated were most sensitive to nitrofurantoin 23(64%) followed by gentamicin 12(33%), ceftriaxone 11(31%), Augmentin 11(31%), ciprofloxacin 10(28%) and ofloxacin 8(22%). There was statistically significant difference between the ages (p<0.05) and indications for surgery (p<0.05) in both groups. A positive correlation among indications for prostatectomy, urinary tract infections and catheterization (p<0.05). Conclusion: The most sensitive antibiotics were nitrofurantoin, gentamicin, ceftriaxone, and Augmentin and these should be chosen in men with benign prostatic antibiotics who requires catheterization. There is a correlation among indications for prostatectomy, urinary tract infections and catheterization.