title: Prevention of urinary tract infections in palliative radiation for vertebral metastasis and spinal compression: a pilot study in 71 patients.
abstract: OBJECTIVE
  To assess the impact of bladder instillations of hyaluronic acid (HA) on the prevalence of urinary tract infection (UTI) in patients receiving emergency radiotherapy for metastatic spinal cord compression.
  
  
  METHODS
  Patients were recruited consecutively at one center and assigned to usual care (UC) (n = 34, mean age 62.2 years) or UC with once-weekly HA instillation (UC + HA) (Cystistat: 40 mg in 50 mL phosphate-buffered saline) (n = 37; mean age, 63.1 years). All patients had an indwelling catheter and received radiotherapy. UTI status was assessed at baseline and during hospitalization.
  
  
  RESULTS
  At baseline, patient groups were comparable, except for the prevalence of UTI at baseline, which was 11.8% and 0% in the UC and UC + HA patients, respectively (p = 0.0477). During hospitalization, 76.5% (vs. 11.8% at baseline, p < 0.0001) of the UC patients had a UTI compared with 13.5% (vs. 0% at baseline, p = 0.0541) of the UC + HA patients (p < 0.0001). Both groups were hospitalized for similar periods (19.8 days [UC] vs. 18.5 days, p = 0.4769) and received equivalent radiotherapy sessions (4.6 [UC] vs. 5.8 sessions, p = 0.2368).
  
  
  CONCLUSIONS
  Patients receiving UC + HA had a 5.7-fold decrease in UTI prevalence over the hospitalization period compared to UC patients, suggesting that bladder instillations of HA effectively prevent UTI in patients with indwelling catheters receiving radiotherapy for nerve compression.
authors.affiliation: Servicio de Oncologia Radioterapica, Hospital Universitario Doce de Octubre, Madrid, Spain. amanas.hdoc@salud.madrid.org
authors.forename: Ana
authors.initials: A
authors.lastname: Mañas
authors.forename: Luis
authors.initials: L
authors.lastname: Glaría
authors.forename: Carmen
authors.initials: C
authors.lastname: Peña
authors.forename: Amalia
authors.initials: A
authors.lastname: Sotoca
authors.forename: Eduardo
authors.initials: E
authors.lastname: Lanzós
authors.forename: Castalia
authors.initials: C
authors.lastname: Fernandez
authors.forename: Marc
authors.initials: M
authors.lastname: Rivière
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage*; D000283:Administration, Intravesical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002408:Catheters, Indwelling / Q000009:adverse effects; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D015995:Prevalence; D013117:Spinal Cord Compression / Q000532:radiotherapy*; D013125:Spinal Neoplasms / Q000532:radiotherapy* / Q000556:secondary*; D014546:Urinary Catheterization / Q000009:adverse effects; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000517:prevention & control*
chemical_list: D000276:Adjuvants, Immunologic; D006820:Hyaluronic Acid