Lack of morbidity from urodynamic studies in children with asymptomatic bacteriuria.
OBJECTIVE
Patients on clean intermittent catheterization (CIC) have a high rate of asymptomatic bacteriuria. Although prophylactic antibiotics for routine surgical procedures in patients with bacteriuria is common practice, the role of prophylaxis for invasive diagnostic procedures remains unclear. The aim of this study was to investigate the morbidity associated with urodynamic evaluation in patients with asymptomatic bacteriuria.


METHODS
Routine urodynamic evaluation was performed in 69 pediatric patients (mean age 10 years). Ninety-six percent had a neurogenic bladder, and most were on CIC. Routine urine cultures were obtained at the time of the cystometrogram. Forty-six patients had positive urine cultures, and 23 patients with sterile urine served as a comparison. Patients were evaluated subjectively for symptoms of a urinary tract infection (UTI) within 1 week of the procedure. The results of the cystometrograms were compared between the patients with and without bacteriuria.


RESULTS
No patient developed symptomatic UTI after the urodynamic studies. Overall, 65% of the patients with and 52% of the patients without bacteriuria had adequate capacity and compliance, and there was no difference in the urodynamic findings between the patients with and without bacteriuria (P = 0.4).


CONCLUSIONS
Urodynamic studies were performed safely in the presence of asymptomatic bacteriuria in the present study. Therefore, routine use of urine cultures or prophylactic antibiotics before urodynamic studies in pediatric patients with a neurogenic bladder does not appear to be indicated.
Shekarriz
B
B
Department of Urology, Wayne State University School of Medicine and Children's Hospital of Michigan, Detroit 48201, USA.
Upadhyay
J
J
Freedman
A L
AL
Fleming
P
P
Barthold
J S
JS
González
R
R
D001437:Bacteriuria / Q000503:physiopathology*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D014546:Urinary Catheterization; D014552:Urinary Tract Infections / Q000209:etiology*; D014563:Urodynamics