ArticleWorld journal of urology2025
Assessing peri-operative antibiotic administration practices amongst urologic surgeons performing holmium laser enucleation of the prostate worldwide.
Article in World journal of urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeHolmium Laser Enucleation of the Prostate (HoLEP) is a size-independent surgical treatment for benign prostatic hypertrophy. There is currently a lack of data on peri-operative antibiotic prescribing patterns for HoLEP and, thus, no consensus on optimal practices. This study aims to assess peri-operative antibiotic prescribing practices for HoLEP.
methodsMembers of the Endourological Society (EUS) were invited by e-mail to complete a REDCap survey. The survey inquired about surgeons' practice setting, training, surgical volume, antibiotic prescribing practices and explored different factors that might affect antibiotic choice and duration. A p-value of < 0.05 was determined to be statistically significant.
resultsA total of 70 Urologists (66 male, 4 female) reported that they performed an average of 108 HoLEPs per year with a mean clinical experience of 11 years. In the case of a negative pre-operative urine culture with a patient who is not catheterized/intermittently self-catheterizing (C/ISC), 96% of urologists would only give a single peri-operative dose of antibiotic. If the patient is C/ISC then 49% of Urologists would give more than a single dose of peri-operative antibiotic when the urine culture is negative. If the pre-operative urine culture is negative, 39% of surgeons would prescribe post-operative antibiotics even when the patient is not C/ISC and this increased to 64% if the patient is C/ISC. The most common factors urologists considered when prescribing antibiotic prophylaxis/therapy were positive urine culture, catheterization status, and a history of recurrent UTIs. Non-academic urologists administered post-operative prophylaxis more often (p < 0.05) and urologists with more experience treated a positive urine culture for a shorter period.
conclusionThere is significant variability for peri-operative antibiotic prescribing practices prior to HoLEP. In general, more antibiotics are prescribed if the patient has a history of C/ISC or infection. Further clinical studies are needed to identify optimal antibiotic prescribing protocols prior to HoLEP.
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