Is it safe to carry out flexible cystoscopy when urinary dipstick is positive for 'infection'? Results of a prospective clinical study
BAUS ePoster online library. Trail M.
Jun 26, 2018; 211352
Mr. Matthew Trail
Mr. Matthew Trail
Login now to access Regular content available to all registered users.

You may also access this content "anytime, anywhere" with the Free MULTILEARNING App for iOS and Android
Rate & Comment (0)
Introduction: There is significant under-utilisation of valuable NHS resources when patients scheduled for flexible cystoscopy are cancelled consequent to positive pre-cystoscopy urinalysis, despite being asymptomatic for UTI. With our pilot evaluation (JCU 2017;10(2S):7-82) supporting a protocol avoiding automatic cancellation, we performed a larger study to primarily identify the association between the pre-flexible cystoscopy urinary Leucocyte-esterase, Nitrites, urine culture and post-cystoscopy UTI, whilst utilising this protocol.

Patients and Methods: We carried out a prospective clinical study in a high-volume UK centre, recruiting all patients undergoing flexible cystoscopy over a 6-month period. Urinalysis was carried out prior to cystoscopy in all patients. Cystoscopy was carried out regardless of the dipstick result, unless patients were symptomatic, in which case they were treated and rescheduled. Patients asymptomatic but considered 'high-risk' for UTI (on the basis of pre-determined criteria) were given prophylactic Gentamicin prior to cystoscopy. Every patient was followed up by a phone call and urine culture when applicable. We defined post-cystoscopy UTI as one that developed within 2 weeks of the procedure. Analysis of association was carried out.

Results: From over 2000 patients, preliminary results suggest that the overall risk of developing post-cystoscopy UTI in this cohort is low. While Leucocyte-esterase and Nitrite positivity appear to carry a slightly higher risk of developing a UTI, this risk was not clinically significant. The incidence of urosepsis is very low.

Conclusion: It appears safe to carry out flexible cystoscopy in asymptomatic patients with positive urinary Leucocyte-esterase and/or Nitrites, without the need for routine prophylactic antibiotics.
    This eLearning portal is powered by:
    This eLearning portal is powered by MULTIEPORTAL
Anonymous User Privacy Preferences

Strictly Necessary Cookies (Always Active)

MULTILEARNING platforms and tools hereinafter referred as “MLG SOFTWARE” are provided to you as pure educational platforms/services requiring cookies to operate. In the case of the MLG SOFTWARE, cookies are essential for the Platform to function properly for the provision of education. If these cookies are disabled, a large subset of the functionality provided by the Platform will either be unavailable or cease to work as expected. The MLG SOFTWARE do not capture non-essential activities such as menu items and listings you click on or pages viewed.

Performance Cookies

Performance cookies are used to analyse how visitors use a website in order to provide a better user experience.

Save Settings