Mp11-07 Soft Tissue Infections After Holep: An Under-Described Complication

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Prostate & Genitalia (MP11)1 May 2024MP11-07 SOFT TISSUE INFECTIONS AFTER HOLEP: AN UNDER-DESCRIBED COMPLICATION Emily C. Serrell, Madison T. Taychert, Ethan Richmond, Robert Tyllo, Ali Antar, Margaret Knoedler, Christopher Manakas, Daniel Gralnek, and Matthew D. Grimes Emily C. SerrellEmily C. Serrell , Madison T. TaychertMadison T. Taychert , Ethan RichmondEthan Richmond , Robert TylloRobert Tyllo , Ali AntarAli Antar , Margaret KnoedlerMargaret Knoedler , Christopher ManakasChristopher Manakas , Daniel GralnekDaniel Gralnek , and Matthew D. GrimesMatthew D. Grimes View All Author Informationhttps://doi.org/10.1097/01.JU.0001008564.85995.11.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Holmium Laser Enucleation of the Prostate (HoLEP) is a size independent surgical treatment for benign prostatic hyperplasia (BPH). While post-HoLEP symptomatic urinary tract infection (UTI) occur in 3-20%, the incidence of soft tissue infections (epididymitis and/ or orchitis (EO)) is not well described. Following transurethral resection of the prostate (TURP), EO occur at a 1-2% rate. In contrast to TURP, HoLEP involves high pressure irrigation in close proximity to the surgical capsule. We hypothesize that high pressure may drive an increased risk of EO. Herein, we aim to determine the rate and risk factors for infectious complications overall and soft tissue infections specifically after HoLEP. METHODS: We randomly sampled 300 patients from a prospectively maintained database of HoLEP patients operated by 5 surgeons from 6/1/2018 to 1/1/2022 at a single tertiary center. Comprehensive clinical data and infectious complications were abstracted from the clinical record. UTI was defined as storage symptoms and a urine culture with>100,000 colony forming units of pathogenic organism; EO was defined as patient-reported pain and exam or ultrasound consistent with EO. RESULTS: Of 300 HoLEP patients 26 (8.7%) experienced an infectious complication within 90 days of surgery. Infectious complications included UTI (n=16, 61.5%) and EO (n=10, 38.5%). All EO with positive culture were gram negative bacteria (n=9), while UTI were mixed (Table 1).Preoperative characteristics were similar in patients with and without infectious complications. Longer post-HoLEP catheter duration (4.2 vs 2.7 days, p=0.01) was associated with infectious complications overall but not specifically with EO. UTI vs EO was not associated with preoperative bacteriuria, history of recurrent UTI, or post-operative severity of illness (e.g. need for admission (n=6) or treatment as outpatient (n=20)). CONCLUSIONS: We identified a 3% rate of soft tissue infections after HoLEP in the context of an 8.7% overall rate of infectious complications. Patients with longer post-operative catheter duration were at higher risk of overall infectious complications but not specifically for EO. These data suggest that HoLEP patients may be at increased risk of soft tissue infections compared to other BPH surgical modalities and support early catheter removal when feasible. Source of Funding: NA © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e152 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Emily C. Serrell More articles by this author Madison T. Taychert More articles by this author Ethan Richmond More articles by this author Robert Tyllo More articles by this author Ali Antar More articles by this author Margaret Knoedler More articles by this author Christopher Manakas More articles by this author Daniel Gralnek More articles by this author Matthew D. Grimes More articles by this author Expand All Advertisement PDF downloadLoading ...