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01-05-2021 | Cystectomy | Original Article

The natural course of urinalysis after urinary diversion

Authors: Giuseppe Magistro, Lukas Zimmermann, Robert Bischoff, Thilo Westhofen, Tobias Grimm, Boris Schlenker, Christian G. Stief, Julian Marcon

Published in: World Journal of Urology | Issue 5/2021

Abstract

Objective

To evaluate the impact of urinary diversion on regular features of urinalysis and to screen for risk factors of infection-related complications.

Methods

We conducted a retrospective, single-centre study of 429 patients who underwent open radical cystectomy. Patients were followed for 12 months and data of the complete urinalyses were analysed at three pre-defined time points.

Results

Two weeks after surgery, dipstick testing with positive reactions for leukocyte esterase and haemoglobin were confirmed in 80.7% and 80% after ileal conduit (IC) and orthotopic ileal neobladder (NB), respectively. Every patient was positive for these parameters 12 months after surgery. Correspondingly, the microscopic examination detected leukocytes (84% vs. 85.4%), erythrocytes (82.8% vs. 83.8%) and bacteria (94.3% vs. 96.8%) following IC and NB reconstruction. After 12 months, all parameters were positive irrespective of the type of urinary diversion. Two weeks after surgery positive urine cultures were obtained in more than 50% of cases after IC (52.5%) and NB (60.5%) (p > 0.05). All urine cultures were positive after 12 months with significantly more poly-microbial results found after NB (81.3%) compared with IC (67.2%) (p = 0.018). In univariate and multivariate logistic regression analysis the presence of hydronephrosis was independently associated with the occurrence of infectious complications (OR 4.2; CI 95% 1.525–11.569; p = 0.006).

Conclusion

A positive urinalysis is a common finding after urinary diversion. Hydronephrosis is a serious risk factor with respect to infection-related complications. The simple fact of a positive urinalysis does not warrant antimicrobial treatment.

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Title: The natural course of urinalysis after urinary diversion
Authors: Giuseppe Magistro
Lukas Zimmermann
Robert Bischoff
Thilo Westhofen
Tobias Grimm
Boris Schlenker
Christian G. Stief
Julian Marcon
Publication date: 01-05-2021
Publisher: Springer Berlin Heidelberg
Keywords: Cystectomy
Urinary Tract Infection
Urinalysis
Published in: World Journal of Urology / Issue 5/2021
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-020-03355-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The natural course of urinalysis after urinary diversion

Abstract

Objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

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