A Prospective Audit of Urinary Tract Infection Incidence following the use of Endosheath® for Flexible Cystoscopy

Main Article Content

Omar Al-Mula Abed
Shaun Trecarten
Shahid Islam
Ananda Kumar Dhanasekaran

Keywords

Endosheath, Flexible cystoscopy, Urinary infection

Abstract

Objectives


To assess the incidence of bacteriuria and urinary tract infection following use of Endosheath®, and to assess patient comfort and satisfaction post-procedure.


 Patients and Methods


One hundred thirty-five patients undergoing Endosheath® flexible cystoscopy (FC) were prospectively identified. Patients were excluded if pre-procedure urinalysis or symptoms suggested infection. Those who underwent FC were asked to provide a urine sample 72 hours post-procedure, assessing for bacterial culture and sensitivity. Patients completed a questionnaire assessing comfort, pain and whether they would recommend the procedure to others if required.


 Results


Of the 135 patients, 117 patients returned their post-procedure samples and processed. Thirteen (11.1%) of the urine cultures samples were positive. Four (3.4%) of this 13 patients had symptoms of urinary tract infection (UTI) and were treated with antibiotics. One hundred and seven (79%) patients found the procedure comfortable and 104 (77%) patients would recommend the procedure to others.


 Conclusions


Flexible Cystoscopy utilising Endosheath® appears to have comparable incidence of bacteriuria and UTI post procedure compared with standard FC, and is well tolerated by most patients.

Downloads

Download data is not yet available.
Abstract 374 | pdf Downloads 330

References

1. O’Sullivan DC, Chilton CP. Flexible cystoscopy. Br J Hosp Med 1994;51:340–45.
2. Kavoussi LR, Clayman RV. Office flexible cystoscopy. Urol Clin North Am 1988;15:601–608.
3. Burke DM, Shackley DC, O’Reilly PH. The community-based morbidity of flexible cystoscopy. BJU Int 2002;89:347–49.
4. Zeng S, Zhang Z, Bai Y, et al. Antimicrobial agents for preventing urinary tract infections in patients undergoing cystoscopy. Cochrane Database Syst Rev; 2016. doi: 10.1002/14651858.cd012305.
5. Krebs A, Borin JF, Kim IY, et al. Evaluation of practice efficiency with a novel sheathed flexible cystoscope: a randomized controlled trial. Urology 2007;70:883–87.
6. McCombie SP, Carmichael JP, Banerjee S, et al. Urinary tract infection following flexible cystoscopy: a comparison between sterilised cystoscopes and disposable sterile sheaths. J Clin Urol 2013;6:220–24.
7. Jørgensen PH, Slotsbjerg T, Westh H, et al. A microbiological evaluation of level of disinfection for flexible cystoscopes protected by disposable endosheaths. BMC Urol 2013;13:46.
8. Kimuli M, Lloyd SN. Out-patient flexible cystoscopy Using a disposable slide-onTM Endosheath system. Ann R Coll Surg Engl 2007;89:426–30.
9. Lawrentschuk N, Chamberlain M. Sterile disposable sheath system for flexible cystoscopes. Urology 2005;66:1310–13.
10. Zhang Z, Cao Z, Xu C, et al. Better irrigation delivers better vision: an exploratory study of a novel continuous irrigation sheath for a flexible cystoscope. Urology 2013;81:25–29.
11. Winter SCA, Thirwell A, Jervis P. Flexible nasendoscope with a disposable-sheath system versus standard nasendoscopy: a prospective, randomized trial. Clin Otolaryngol Allied Sci 2002;27:81–83.
12. Bretthauer M, Hoff G, Thiis-Evensen E, et al. Use of a disposable sheath system for flexible sigmoidoscopy in decentralized colorectal cancer screening. Endoscopy 2002;34:814–18.
13. Colt HG, Beamis JJ, Harrell JH, et al. Novel flexible bronchoscope and single-use disposable-sheath endoscope system. A preliminary technology evaluation. Chest 2000;118:183–87.
14. Mayinger B, Strenkert M, Hochberger J, et al. Disposable-sheath, flexible gastroscope system versus standard gastroscopes: a prospective, randomized trial. Gastrointest Endosc 1999;50:461–67.
15. Alverado C, Anderson A, Maki D. Microbiologic assessment of disposable sterile endoscopic sheaths to replace high-level disinfection in reprocessing: A prospective clinical trial with nasopharyngoscopes. Am J Infec Cont 2009;37:408–13.

16. Greenstein A, Greenstein I, Senderovich S, et al. Is diagnostic cystoscopy painful? Analysis of 1,320 consecutive procedures. Int Braz J Urol 2014;40:533–38.
17. Noronha AM, Brozak S. A 21st Century nosocomial issue with endoscopes. BMJ 2014;348:g2047.