Compare Frequency of Symptomatic Pyuria in Patients Undergoing Flexible Cystoscopy with or without Antibiotic Prophylaxis

Abstract

Cystoscopy is one of the most commonly performed urological procedures with purpose to inspect lower urinary tract anatomy and evaluation of lower urinary tract symptoms as well as various pathologies of the urethra, prostate and bladder. The procedure is carried out by inserting an optical instrument (cytoscope) into the urethra and the bladder. Currently, no antibiotic prophylaxis has been recommended for routine flexible cystoscopy, except in high risk patients. The patients in our population undergoing cystoscopy belonged to two groups. One was given prophylactic antibiotic dose of Fosfomycin per orally while other received placebo and frequency of pyuria was seen at 10^th day.

Objective: To compare frequency of symptomatic pyuria in patients undergoing flexible cystoscopy with or without antibiotic prophylaxis.

Material and Methods: Patients were divided into two groups. Group – 1 with Antibiotic prophylaxis while Group – 2 with placebo. All surgeries will be performed by a consultant urologist and were assisted by principal investigator. The frequency of symptomatic pyuria was calculated.

Data analysis: Collected data was analyzed on SPSS version 16.Descriptive statistics was calculated for both qualitative and quantitative variables. For qualitative variables like gender frequency percentages were calculated. For quantitative variables like age, operation time mean ± SD were calculated. Effect modifiers like age, gender, duration of symptoms were controlled by stratification. Post stratification independent sample t-test was applied keeping p-value ≤ 0.05 as significant.

Results: A chi-square test indicates there was no significant difference in the proportion of symptomatic pyuria(21.9%) as compared with the value of 27.7% in placebo group(X2=1.695, n = 382  p = 0.193. This supported our null hypothesis stating that there is no difference in symptomatic pyuria between antibiotic prophylaxis group vs placebo group.

Conclusion: There was no significant effect on symptomatic pyuria with or without antibiotic prophylaxis.

Keywords: cystoscopy, pyuria, antibiotic prophylaxis, UTI