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19–22 APRIL, 2017, BARCELONA, SPAIN
16:26–16:29
S11-5 (PP)
IMPACT OF POSITIVE PREOPERATIVE URINE CULTURES
BEFORE PEDIATRIC LOWER URINARY TRACT
RECONSTRUCTIVE SURGERY
Alexander SMALL
1
, Alejandra PEREZ
1
, Stanley DESIRE
1
, Michael LIPSKY
1
,
Lisa CREELMAN
2
, Pasquale CASALE
2
and Shumyle ALAM
2
1) NewYork-Presbyterian Hospital / Columbia University Medical Center, Department of Urology, New York, USA -
2) NewYork-Presbyterian Hospital / Morgan Stanley Childrens Hospital of New York, Department of Urology, New York,
USA
PURPOSE
Preoperative urinary tract infections have been shown to correlate with postoperative complica-
tions including sepsis, surgical site infections, and kidney failure in surgical literature. Children
who undergo lower urinary tract reconstruction (LUTR) for congenital malformations or neurogenic
bladder often have asymptomatic bacteriuria. We studied the prevalence and impact of positive
preoperative urine cultures (PPUC) before pediatric LUTR.
MATERIAL AND METHODS
We retrospectively reviewed pediatric LUTR procedures utilizing bowel segments (including cath-
eterizable channels, enterocystoplasties, and continent diversions) performed by a single surgeon
2/2014-7/2016. Preoperative urine cultures were analyzed 1-2 days before surgery. Baseline
characteristics and 90-day infection/readmission rates were compared between patients with and
without PPUC.
RESULTS
54 patients with mean age 10+/-6 years underwent LUTR. 28 patients (51%) had PPUC. None
were symptomatic. All started antibiotics at the time of surgery and continued while inpatient.
Postoperatively, 20% had inpatient infections with no difference between groups (9% PPUC versus
11% negative, p=0.69). Length of stay was the same in both groups (median 11 days, p=0.96).
Within 90 days of discharge, 28% of patients were readmitted (11% PPUC versus 16% negative,
OR1.83, p=0.32), 18% experienced urinary tract infections (7% PPUC versus 11% negative,
OR0.58, p=0.45), and 4% developed surgical site infections (2% PPUC versus 2% negative,
OR0.96, p=0.96).
CONCLUSIONS
There is a high prevalence of PPUC in patients undergoing LUTR, but this factor did not appear
to impact postoperative infection risk or hospital readmission. This study supports the safety of
performing complex LUTR in patients with PPUC and may provide rationale for the use of broad-
spectrum perioperative antibiotics.