Single preoperative bladder instillation of povidone-iodine for the prevention of postprostatectomy bacteriuria and wound infection.
OBJECTIVE
To study the effectiveness of preoperative bladder washing with povidone-iodine to prevent postprostatectomy wound infection.


METHODS
Patients with an indwelling catheter and scheduled for prostatectomy were divided into two groups. In patients in group 1 (n = 76) the indwelling catheter was simply removed without bladder irrigation. Patients in group 2 (n = 80) had their bladder washed with a nondiluted solution of povidone-iodine before surgery.


METHODS
One hundred fifty-six consecutive patients with an indwelling catheter and bacteriuria. Mean age was 64 years. All patients had an open prostatectomy during the 12-month study period. Patients undergoing open prostatectomy during the first 6 months of the study had no bladder irrigation and served as the control group. Patients undergoing open prostatectomy during the following 6 months had a bladder instillation with povidone-iodine.


RESULTS
Wound infection appeared in 17 of 76 patients (22.4%) without bladder washing and in 4 of 80 patients (5%) when 50 to 60 ml of the solution was retained in the bladder for 10 to 13 minutes (p = .001). The incidence of postoperative bacteriuria remained unchanged in the control group (100%) but was reduced to 22.5% in the treated group (p = .001). Statistical comparisons of incidence were done using the chi square test.


CONCLUSIONS
It has been demonstrated that the use of preoperative bladder instillation of povidone-iodine may be highly effective in the prevention of postprostatectomy wound infection and in reducing the incidence of bacteriuria in patients with an indwelling catheter and urine colonization.
Richter
S
S
Department of Urology, Sapir Medical Center, Kfar Saba, Israel.
Kotliroff
O
O
Nissenkorn
I
I
D000283:Administration, Intravesical; D000368:Aged; D000369:Aged, 80 and over; D001437:Bacteriuria / Q000382:microbiology / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011206:Povidone-Iodine / Q000008:administration & dosage*; D011300:Preoperative Care / Q000379:methods*; D011468:Prostatectomy; D013530:Surgical Wound Infection / Q000382:microbiology / Q000517:prevention & control*; D007507:Therapeutic Irrigation; D001745:Urinary Bladder Diseases / Q000382:microbiology / Q000517:prevention & control
D011206:Povidone-Iodine