Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jun;45(3):178-185.
doi: 10.5535/arm.20241. Epub 2021 Jun 14.

Should We Delay Urodynamic Study When Patients With Spinal Cord Injury Have Asymptomatic Pyuria?

EunYoung Kim  1 , Hye Jin Lee  1 , Onyoo Kim  1 , In Suk Park  2 , Bum-Suk Lee  1
Affiliations

Should We Delay Urodynamic Study When Patients With Spinal Cord Injury Have Asymptomatic Pyuria?

EunYoung Kim et al. Ann Rehabil Med. 2021 Jun.

Abstract

Objective: To assess the incidence of urinary tract infection (UTI) with post-urodynamic study (post-UDS) in patients with spinal cord injury (SCI) and study its relationship with pre-UDS pyuria.

Methods: Patients with SCI who were hospitalized and underwent UDS during a 4-year period were reviewed. Patients with pre-test lower urinary tract symptoms were excluded. Urinalysis and urine culture were performed before and 24 hours after UDS. Prophylactic antibiotics were administered for 5 days starting from the morning of the UDS. UTI was defined as bacteriuria with accompanying symptoms.

Results: Of 399 patients reviewed, 209 (52.4%) had pyuria in pre-UDS urinalysis, and 257 (64.4%) had bacteriuria in pre-UDS culture. Post-UDS UTI occurred in 6 (1.5%) individuals who all complained of fever: 5 (2.4%) of the post-UDS UTI cases occurred in patients with pre-UDS pyuria, and 1 (0.5%) in a person without. The differences between groups were not statistically significant (p=0.218). Of 221 patients with bacteriuria (gram-negative isolates) on pre-UDS culture, resistance to ciprofloxacin, cephalosporin, and trimethoprim/sulfamethoxazole (TMP/SMT) was noted in 52.9% (117 cases), 57.0% (126 cases), and 38.9% (86 cases), respectively.

Conclusion: No difference was found in the prevalence of post-UDS UTI based on the presence of pyuria in pre-UDS urinalysis. UDS may be performed even in SCI cases of pre-UDS pyuria without increasing the prevalence of post-UDS UTI if prophylactic antibiotics are administered. TMP/SMT could be used as a first-line antibiotic for the prevention of post-UDS UTI in Korea.

Keywords: Bacteriuria; Pyuria; Spinal cord injuries; Urinalysis; Urinary tract infections; Urodynamics.

PubMed Disclaimer

Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.
Types of antibiotics prescribed before urodynamic study (UDS). UTI, urinary tract infection; TMP/SMT, trimethoprim/sulfamethoxazole.
Fig. 2.
Fig. 2.
Pre-urodynamic study results of urine culture resistance for ciprofloxacin, cephalosporin, and trimethoprim/sulfamethoxazole (TMP/SMT) in gram-negative isolates.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Albayrak I, Caliskan A Levendoglu F, Ozerbil OM, Dagi HT. Characteristics of urinary tract infections in patients with spinal cord injuries hospitalized at a rehabilitation centre. Cyprus J Med Sci. 2016;1:17–21.
    1. Whiteneck GG, Charlifue SW, Frankel HL, Fraser MH, Gardner BP, Gerhart KA, et al. Mortality, morbidity, and psychosocial outcomes of persons spinal cord injured more than 20 years ago. Paraplegia. 1992;30:617–30. - PubMed
    1. Edokpolo LU, Stavris KB, Foster HE., Jr Intermittent catheterization and recurrent urinary tract infection in spinal cord injury. Top Spinal Cord Inj Rehabil. 2012;18:187–92. - PMC - PubMed
    1. Khanna R, Sandhu AS, Doddamani D. Urodynamic management of neurogenic bladder in spinal cord injury. Med J Armed Forces India. 2009;65:300–4. - PMC - PubMed
    1. Tsai SW, Kung FT, Chuang FC, Ou YC, Wu CJ, Huang KH. Evaluation of the relationship between urodynamic examination and urinary tract infection based on urinalysis results. Taiwan J Obstet Gynecol. 2013;52:493–7. - PubMed

LinkOut - more resources