Risk factors in delayed postoperative hematuria after transurethral prostatectomy: The role of preoperative leukocytosis and preliminary antibiotic treatment

Abstract

Background: We aim to find out the risk factors of delayed postoperative hematuria and the role of preliminary antibiotic treatment in patients receiving transurethral resection of prostate or laser prostatectomy. Materials and Methods: The study consisted of 713 patients undergoing surgical intervention for benign prostatic hyperplasia at a single medical center from January 2016 to December 2016. Severe delayed postoperative hematuria was defined as hematuria requiring an emergency department visit or a surgical intervention within 30 days after operation. Variables of interest included age, body mass index, preoperative status of urinary catheter, prostate volume, preoperative diagnosis of pyuria, preliminary antibiotic treatment, duration of operation, type of operation, and use of antiplatelet agents or 5 alpha reductase inhibitors. Results: Six hundred and twenty-three of the 713 patients had available data of preoperative transrectal ultrasonography a year before their operation. Delayed postoperative hematuria occurred in 41 patients within 30 days after operation. No statistical significance was found between the different types of operation. Multivariate analysis revealed that the odds of delayed postoperative hematuria increased with preoperative serum prothrombin time (PT) (odds ratio [OR] 1.49, 1.03–1.87), serum white blood cell (WBC) count (OR 1.26 1.05–1.50), serum creatinine (OR 1.59, 1.01–2.50); decreased with preliminary antibiotic treatment (OR 0.26 0.09–0.77). Conclusion: Higher preoperative serum PT, WBC count, and creatinine were associated with higher risk of delayed postoperative hematuria, while preliminary antibiotic treatment was associated with lower risk of delayed postoperative hematuria.

Keywords

• benign prostatic hyperplasia
• delayed postoperative hematuria
• preliminary antibiotic treatment