Comparison In High-risk Factors Of Urinary Tract Infection After Transurethral Resection Of The Prostate(TURP) And Transurethral Holmium Laser Enucleation Of The Prostate(HoLEP)

Objective To investigate the incidence of urinary tract infection after transurethral resection of the prostate(TURP)and transurethral holmium laser enucleation of the prostate(HoLEP)in patients with benign prostatic hypertrophy(BPH),and especially high-risk factors of postoperative urinary tract infection,so as to provide a clinical guidance for reduction of postoperative urinary tract infection.Methods The clinical data of BPH patients undergoing TURP(TURP group,n = 153)and BPH patients receiving HoLEP(HoLEP group,n = 146)in the Department of Urinary Surgery of our hospital between January 2015 and January 2018 were retrospectively analyzed.The incidence and high-risk factors of postoperative urinary tract infection in the patients were analyzed.Results 1.Postoperative urinary tract infection occurred in 28patients(28/153;18.30%)in the TURP group and 14 patients(14/146;9.59%)in the HoLEP group,presenting a statistical difference.In the TURP group,153 samples were detected,and the detection rate of pathogenic bacteria was 18.30%(28/153).A total of 64 strains of pathogenic bacteria were detected,with Escherichia coli the most(35.94%),among which gram-negative bacteria accounted for 62.50%and gram-positive cocci for 34.38%.In the HoLEP group,146 samples were detected,and the detection rate of pathogenic bacteria was 9.59%(14/146).A total of 40 strains of pathogenic bacteria were detected,with Escherichia coli the most(37.50%),among which gram-negative bacteria accounted for 62.50% and gram-positive cocci for 35.00%.2.Single-factor analysis of patients with postoperative urinary tract infection in the TURP group revealed that age ? 60 years,combined diabetes,combined hypertension,surgical duration ? 1 h,preoperative urethral catheterization,mass of the resected prostate ? 30 g,duration of postoperative urethral catheterization ? 3 d and postoperative hospital stay length ? 7 d were high-risk factors of postoperative urinary tract infection.Multiple-factor logistic regression analysis showed that combined diabetes(OR = 1.783,95%CI = 1.203~3.864),surgical duration ? 1 h(OR = 2.731,95%CI = 1.263~3.26),preoperative urethral catheterization(OR = 5.731,95%CI = 2.531~6.453),duration of postoperative urethral catheterization ? 3 d(OR = 3.297,95%CI =2.351~3.936)and hospital stay length ? 7 d(OR = 7.125,95%CI =5.328~9.386)were independent risk factors of postoperative urinary tract infection in the TURP group.3.Single-factor analysis of patients with postoperative urinary tract infection in the HoLEP group demonstrated that age ? 60 years,combined diabetes,combined hypertension,preoperative urethral catheterization,mass of the resected prostate ? 30 g and duration of postoperative urethral catheterization ? 3 d were high-risk factors of postoperative urinary tract infection.Multiple-factor logistic regression analysis presented that combined diabetes(OR = 1.638,95%CI =1.133~3.524),preoperative urethral catheterization(OR = 4.413,95%CI= 2.412~4.346)and duration of postoperative urethral catheterization ?3 d(OR = 3.162,95%CI = 2.154~3.745)were independent risk factors of postoperative urinary tract infection in the HoLEP group.Conclusion The incidence of postoperative urinary tract infection after TURP is higher than that after HoLEP.In patients with urinary tract infection after TURP and HoLEP,gram-negative bacteria are mainly distributed,with Escherichia coli the most.High-risk factors of urinary tract infection after both TURP and HoLEP include age ? 60 years,combined diabetes,combined hypertension,preoperative urethral catheterization,mass of the resected prostate ? 30 g and duration of postoperative urethral catheterization ? 3 d.In addition,high-risk factors of urinary tract infection after TURP include surgical duration ? 1 h andpostoperative hospital stay length ? 7 d.