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Challenges of catheter associated urinary tract infection: is prevention better than cure?

Catheterisation is a common medical procedure in which a catheter (a hollow flexible tube) is inserted into the bladder in order to facilitate the drainage of urine. Catheters are usually passed into the bladder via the urethra, either to be...

Management of recurrent cystitis

Acute uncomplicated infective cystitis is most commonly seen in healthy women with a frequency of around 0.5-0.7 episodes per woman per year [1]. Around 10% of women report having had an episode of urinary tract infection (UTI) each year and...

Imaging and Intervention in Urinary Tract Infections and Urosepsis

Urinary tract infections (UTIs) are highly prevalent in the community and account for approximately 40% of hospital-acquired infections. Yet, they are often underestimated and under-diagnosed: as one chapter of this book is entitled, nothing is simple about acute pyelonephritis. This...

Prostate biopsies without antibiotic cover – are we there yet?

Transperineal (TP) prostate biopsies are widely replacing the traditional transrectal route due to definite evidence of reduced infective complications. TP biopsies are usually performed with a single dose of antibiotic pre-procedure in most centres. In this article the authors attempt...

Fluoroquinolone resistant rectal colonisation predicts risk of infectious complications after TRPB

Transrectal prostate biopsy (TRPB) has been associated with increased risk of infection between 3.6-5% and sepsis rates of 0.3-3.1% mainly due to fluoroquinolone resistance (FQR). At present, FQ antibiotic prophylaxis is utilised commonly across North America and Europe but due...

HIV / AIDS – implications for the urologist

“It’s no fun to have HIV even though it’s viewed as a chronic, controllable disease. It means being wedded to the health system.” - Philip Berger, Associate Professor in the Department of Family and Community Medicine, Toronto, Canada; and leading...

Suprapubic catheterisation – a core surgical trainee’s perspective

Suprapubic catheters (SPCs) are in widespread usage in medical practice and this review will focus on the pre-assessment, indications, methods and complications that are associated with the insertion of an SPC. Although suprapubic catheter insertions may be done electively or...

The role of continuous prophylactic antibiotics following JJ stent insertion

Urinary tract infections (UTI) and stent-related symptoms (SRS) are frequently recognised complications of ureteric stent placement. Antibiotic administration at induction prior to ureteric stent insertion is recommended by the European Association of Urology (EAU). Commencing prophylactic antibiotics for the ‘entire...

An update on antibiotic prophylaxis in TRUS-guided prostate biopsy

Since its inception in the 1980s, transrectal ultrasound (TRUS)-guided prostate biopsy has remained the standard tool for the histological diagnosis of prostate cancer. There are several advantages to this technique which have led to the widespread use of TRUS in...

Ten years of experience with intravesical and intrasphincteric botulinum toxin A in children

This is one of the longest follow-up studies of botulinum toxin A usage in children with bladder dysfunction in the paediatric literature. Fifty-three children had Botox® (Allergan) injected for a variety of reasons (spina bifida – 18, acquired cord injury...

Rectal swab guided antibiotics for TRUS biopsy

This is a single centre retrospective study to examine the effect of rectal swab culture-directed prophylaxis on the incidence of prostate biopsy associated infections. Secondary objectives were to determine the rate of fluoroquinolone resistance and extended-spectrum beta-lactamase production in local...