Positive preoperative cultures but not bacterial species predict postoperative urine culture results after holmium laser enucleation of the prostate.

Purpose: The purpose of this study was to evaluate risk factors associated with positive urine cultures following holmium laser enucleation of the prostate (HoLEP).

Materials and methods: The data from a prospectively maintained database were analyzed to evaluate urine culture results following HoLEP and determine the contribution of predefined variables (age, prostate size, Charlson comorbidity score, surgical time [surrogate for case difficulty], the presence of a catheter preoperatively, postoperative urinary retention, and preoperative positive culture) on urine culture positivity at 60 days postoperatively. Statistical analyses included logistic regression and ANOVA.

Results: The data from 136 subjects were included in the database and were evaluated at a median of 13.37 ± 6.72 months after their HoLEP. Postoperative positive cultures were noted in 23 subjects (16.91%). Preoperative positive cultures were found to predict positive postoperative urine cultures (odds ratio: 3.78, confidence interval: 1.18-12.78, P = 0.03). However, the preoperative and postoperative results were discordant in 9 of 14 subjects with both positive preoperative and postoperative cultures.

Conclusions: Positive preoperative cultures were predictive of positive postoperative cultures. However, the pre- and postoperative results were often discordant. Host factors increasing susceptibility to bacteriuria may explain these findings.