RESUMEN
INTRODUCTION: Urinary tract infection (UTI) is among the most frequent complications after urinary tract surgical procedures, mainly when catheter placement is necessary. Although the use of American cranberry has been related with a reduced risk of UTI, there is no study reporting the value of its prevention effect against catheter-associated urinary tract infections. MATERIAL AND METHODS: A prospective trial comparing UTI rate (positive urine culture) among 31 patients with double J catheter (JJ) and adding American cranberry (120 mg) in routine prophylactic therapy, and 31 patients with JJ catheter only receiving routine prophylactic therapy. RESULTS: Regarding general characteristics of the populations no significant difference among groups have been found. Only significant differences have been observed when the variables "cranberry treatment" and "dwell time of JJ catheter" were related. "Dwell time of JJ catheter" was higher in patients with UTI (35.9 compared 28.5 days [P=.03]). UTI percentage was lower in cranberry supplemented patient group (12.9 compared to 38.7% [P=.04]). CONCLUSIONS: We can conclude that American cranberry (120 mg) has an adjuvant effect in the prevention of UTI in patients with JJ catheter after surgery.
Asunto(s)
Infecciones Relacionadas con Catéteres/tratamiento farmacológico , Fitoterapia , Extractos Vegetales/uso terapéutico , Proantocianidinas/uso terapéutico , Cateterismo Urinario/efectos adversos , Infecciones Urinarias/tratamiento farmacológico , Vaccinium macrocarpon , Adulto , Profilaxis Antibiótica , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Resultado del TratamientoRESUMEN
INTRODUCTION: Affectation of the bladder after open prostatectomy is demonstrated. Decrease in bladder capacity and bladder compliance, detrusor hyper-or hypo-activity and voiding dysfunction are observed. We propose to investigate the effects of robotic surgery on bladder and sphincter function through the comparative study of preoperative and postoperative urodynamic values 3 months after prostatectomy. MATERIAL AND METHODS: Prospective study of 32 consecutive patients undergoing robotic prostatectomy. They all underwent urodynamic study one month before the intervention and 3 months after the radical prostatectomy. RESULTS: Twenty five percent of patients undergoing robotic prostatectomy showed detrusor hyperactivity accompanied by a decrease in bladder compliance of 30.2 to 21.8 ml/cmH2O. Urethral profile showed diminished functional length of 67 to 44 mm and decreased maximum urethral pressure of 48.5 to 29.3 cmH2O. After robotic prostatectomy 21.8% of patients had detrusor hypoactivity, obstruction decreased between 28.1% to 12.5%. CONCLUSIONS: Decreased bladder compliance, detrusor hypo- or hyperactivity and obstruction improvement observed in the study of the flow pressure have been associated with sphincter involvement. It is part of the complex of lower urinary tract dysfunction that occurs after robotic prostatectomy.