Influencing factors of urinary tract infection after transurethral bipolar plasma enucleation of the prostate in patients with benign prostatic hyperplasia and the early predictive value of serum inflammatory indicators for postoperative urinary tract infection
10.3760/cma.j.cn115396-20240613-00182
- VernacularTitle:BPH患者TUPEP术后尿路感染影响因素及血清炎性指标对术后尿路感染早期预测价值
- Author:
Yingming PENG
1
;
He ZHENG
;
Lijie YUAN
;
Yinggen ZHANG
;
Wen KONG
;
Jiayue TIAN
;
Yanhe CHANG
Author Information
1. 开滦总医院泌尿外科二病区，唐山 063000
- Keywords:
Benign prostatic hyperplasia;
Transurethral bipolar plasma enucleation of the prostate;
Urinary tract infection;
Inflammatory index;
Influencing factors
- From:
International Journal of Surgery
2025;52(2):123-130
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the influence factors of urinary tract infection after transurethral bipolar plasma enucleation of the prostate (TUPEP) in patients with benign prostatic hyperplasia(BPH), and the early predictive value of serum inflammatory indicators for postoperative urinary tract infection.Methods:A total of 300 patients with BPH who received TUPEP treatment in the Department of Urology, Kailuan General Hospital from January 2021 to August 2023 were selected, according to whether they had urinary tract infections after the operation, they were divided into infection group ( n=117) and non-infection group ( n=183). The clinical data of the two groups were collected, and the serum inflammatory indexes of the two groups were recorded within 24 hours after the operation, including white blood cell count (WBC), neutrophil granulocyte (NE%), high-sensitivity C-reactive protein (hs-CRP), serum amyloid A (SAA), procalcitonin (PCT), heparin-binding protein (HBP), interleukin-2 (IL-2), interleukin-4 (IL-4), interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), and serum ferritin (SF). The differences of clinical data and serum inflammatory indexes between the two groups were analyzed. The measurement data of normal distribution were expressed as mean ± standard deviation ( ± s), and independent sample t-test was used for inter-group comparisons. The measurement data of non- normal distribution were represented by median (interquartile range) [ M ( Q1, Q3)], and the Mann-Whitney U test was used for inter-group comparison. The count data were expressed as cases and percentage, and inter-group comparisons were conducted using the Chi-test. Multivariate Logistic regression analysis was used to explored the influencing factors of urinary tract infections in BPH patients after TUPEP surgery. The receiver operating characteristic (ROC) curve was plotted using GraphPad Prism 8.0.1 medical plotting softwar to evaluate the predictive value of serum inflammatory markers and combined detection of multiple markers for early postoperative urinary tract infections. Results:The duration of disease, history of diabetes, international prostate symptom score (IPSS), prostate volume, preoperative serum prostate-specific antigen (PSA) level, preoperative urine residual volume, operation time, intraoperative blood loss, postoperative catheter indwelling time, and hospitalization time in the infection group were higher than those in the non-infection group ( P<0.05). The preoperative 25-hydroxyvitamin D (25OHD) level and maximum urinary flow rate were lower in the infection group than those in the non- infection group ( P<0.05). Multivariate Logistic regression analysis showed that the course of the disease, history of diabetes, IPSS score, prostate volume, preoperative PSA level, preoperative urine residual volume, operation time, intraoperative blood loss, postoperative catheter indwelling time was positively correlated with urinary tract infection after TUPEP ( B=0.660, 0.242, 0.164, 0.125, 0.230, 0.066, 0.382, 0.022, 0.436, P<0.01), and preoperative 25OHD level and preoperative maximum urinary flow rate were negatively correlated with urinary tract infection after TUPEP ( B=-0.216, -0.372, P<0.01). The levels of hs-CRP, SAA, PCT, HBP, IL-2, IL-4, IL-6, IL-8, IL-10, TNF-α, IFN-γ, SF in the infection group were higher than those in the non-infection group ( P<0.001). The ROC curve analysis showed that the area under the curve (AUC) of hs-CRP, SAA, PCT, HBP, IL-2, IL-4, IL-6, IL-8, IL-10, TNF-α, IFN-γ, SF in early predicting urinary tract infection after TUPEP in BPH patients were 0.697, 0.775, 0.902, 0.873, 0.884, 0.904, 0.917, 0.823, 0.906, 0.852, 0.807, 0.787. The AUC of the combined detection of multiple serum inflammatory markers was 0.972, the sensitivity and specificity were 93.18% and 96.63%, and the sensitivity and specificity of the combined detection of multiple serum inflammatory markers were higher than those of separate detection. Conclusion:The course of BPH, whether to combine history of diabetes, preoperative IPSS score, prostate volume, preoperative PSA level, preoperative 25OHD level, preoperative maximum urinary flow rate, operation time, intraoperative blood loss, and postoperative catheter indwelling time are influencing factors of urinary tract infection after TUPEP, hs-CRP, SAA, PCT, HBP, IL-2, IL-4, IL-6, IL-8, IL-10, TNF-α, IFN-γ, SF had certain value in the early prediction of urinary tract infection after TUPEP in patients with BPH, the combination of multiple indicators can improve the predictive value of early urinary tract infection.
