ANTIBIOTIC PROPHYLAXIS BEFORE CYSTOSCOPY IN FEMALE PATIENTS: A PROSPECTIVE COMPARATIVE STUDY

Objective: To compare the outcome of single oral dose of ciprofloxacin verses no prophylaxis before minor cystoscopic procedures (diagnostic cystoscopy, check cystoscopy and removal of double J stent) in female patients.

Methodology: A total of 180 female patients were prospectively assessed. All patients had documented “no growth” on pre-procedure urine culture. Ninety female patients were randomized as Group A (No prophylactic antibiotics) and Group B (single oral dose of ciprofloxacin). Postoperatively all patients were observed for 4 hours in-hospital and then on telephone for first 3 days of procedure. Parameters including, burning micturition, fever, hematuria flank pain and urinary retention were recorded.

Results: Overall the median age was 52.4 years (23-74 years), the mean age in group A was 52+6.1 years and in group B was 49.2+7.4 years. There was no statistically significant difference in both groups. In terms of co-morbidities, there was no statistical significant difference in both groups. Majority of our cystoscopy indications were ureteral stent removal, diagnostic cystoscopy and check cystoscopy for surveillance of bladder tumor, both groups were statistically comparable (p=0.09). Post-procedure, majority of patients from both groups remained asymptomatic (group A = 80%, group B =83%). Dysuria was reported by 17.7% of group A patients and 15.5% of group B patients, statistically it was comparable in both groups. Only 3 patients had culture proven urinary tract infections.

Conclusion: There is no difference in patients proceeding for day care cystoscopy procedures with or without taking prophylaxis. Double J stents removal, diagnostic cystoscopy and check cystoscopy can safely be performed without antibiotic prophylaxis. Dysuria can happen up to 17% of patients without prophylaxis. 

Key Words: Antibiotic Prophylaxis, Cystoscopy.