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Pediatric Urodynamic Study Without a Preprocedural Urine Culture, Is It Safe in Clinical Practice?

      OBJECTIVE

      To prove that incidence of UTI after a pediatric urodynamic study (UDS) is low, and that patients without urine culture (UC) analysis prior to a UDS will not have a significant increase in the incidence of UTI (post-UDS UTI).

      METHODS

      Prospective cohort study including consecutive pediatric patients undergoing UDS in a single center for 1 year. Patients were divided in 2 groups: (G1) UDS with a previous negative UC and (G2) UDS without a previous UC analysis. A clean UC was obtained in all patients at the moment of the UDS (UDS-UC). Primary outcome was post-UDS UTI. Secondary outcome was to compare UC cost per patient and cancellation rates in each group. All patients were followed 15 days after the UDS to detect onset of UTI symptoms.

      RESULTS

      Four hundred two patients were included, 198 patients in G1 and 204 patients in G2. Median age was 9 years old. Both groups were similar in terms of demographic and clinical records data except for a proportion of patients on CIC which was larger in G2 (P <.008). Overall incidence of post-UDS UTI was 0.7% (3/402), G2 incidence (0.98%) being slightly higher than G1 (0.50%; P <.58). UDS-UC was positive in 32% of G1 vs 55% in G2 (P <.001). About 98% of patients with positive UDS-UC did not progress to symptomatic UTI. G1 cost was 140% higher than G2.

      CONCLUSION

      Overall incidence of post-UDS UTI is low (0.7%). Patients without UC prior to UDS did not have a significant increase in post-UDS UTI.

      Abbreviations:

      UDS (urodynamic study), VUDS (video-urodynamic study), UTI (urinary tract infection), UC (urine culture), Post-UDS UTI (post urodynamic urinary tract infection), CIC (clean intermittent catheterization), NLUTD (neurogenic lower urinary tract dysfunction), VUR (vesico-ureteral reflux), CAP (continuous antibiotic prophylaxis)
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