Secondary haemorrhage following transurethral resection of bladder tumour – is it always related to infection?

Heer, R., Glendinning, R. J., Nesbitt, C. N., Pal, Deepali, Rix, D., Menezes, P. and Johnson, M. I. (2012) Secondary haemorrhage following transurethral resection of bladder tumour – is it always related to infection? British Journal of Medical and Surgical Urology, 5 (2). pp. 61-66. ISSN 1875-9742

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Abstract

Background: We reviewed the empirical use of antibiotics in patients with secondary haemorrhage following transurethral resection of bladder tumour.

Patients and methods: A retrospective review of 2830 patients undergoing TURBT between January 2006 and April 2009 was performed from two large independent urology centres in the UK. Patients with secondary haemorrhage were identified and their urine culture results and risk factors for bleeding were studied.

Result: Secondary haemorrhage causing hospital admission was seen in 2% (51 cases). However, only 14% of these cases had significant bacteriuria on urine culture. In patients with secondary haemorrhage we show potential risk factors for bacteriuria: resection weight greater than 2g (71% versus 28%), muscle invasive bladder cancer (43% versus 20%) and macroscopic residual disease (43% versus 12%); although they did not reach statistical significance. Interestingly there was no significant difference in the clinical parameters supportive of infection between patients with bacteriuria and sterile urine — in particular only 1/51 had a temperature of greater than 37.5°C. Nevertheless, 73% (37/51) of patients were treated with antibiotics.

Conclusion: Typically, patients with secondary haemorrhage following TURBT do not have evidence of demonstrable infection and only a few had evidence of bacteriuria. Routine prescription of antibiotics in secondary haemorrhage following TURBT is therefore not justified.

Item Type:	Article
Uncontrolled Keywords:	MeSH headings; Bladder cancer; Bleeding; Infection
Subjects:	B900 Others in Subjects allied to Medicine
Department:	Faculties > Health and Life Sciences > Applied Sciences
Depositing User:	Becky Skoyles
Date Deposited:	10 May 2019 14:52
Last Modified:	10 Oct 2019 17:19
URI:	http://nrl.northumbria.ac.uk/id/eprint/39271

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