Urinary tract infections in the potential vertebroplasty patient: incidence, significance, and management

Abstract

Percutaneous vertebroplasty has been deferred due to potential complications from urinary tract infections (UTIs). Our aim was to help sort out the types of treatment needed for percutaneous vertebroplasty patients and the length delay for performing the procedure. We searched for information regarding the ramifications of infection from the literature and devised a plan of treatment for the various infectious problems that may occur in patients undergoing percutaneous vertebroplasty. We devised a plan of action for the screening, testing, diagnosis and treatment of patients with a potential UTI who are presenting for a percutaneous vertebroplasty.

Fig 1.

Algorithm for evaluation of patients considered for vertebroplasty (VP). *Dysuria, urine frequency, hematuria, urgency, and suprapubic discomfort. See text for UTI symptoms in the geriatric population. †See Table 2. ‡Start treatment with trimethoprim/sulfamethoxazole 160/800 twice a day (BID) or fluoroquinolone and be guided by sensitivities obtained from urine culture. The duration of treatment is 7–14 days. §Trimethoprim/sulfamethoxazole 160/800 BID is the first-line treatment. Trimethoprim alone, fluoroquinolones for 3 days, or nitrofurantoin for 5–7 days is an alternative option. U/A indicates urine analysis; Pos., positive; Neg, negative.