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Ayoub E, Kutchukian S, Bigot P, Dinh A, Gondran-Tellier B, Robin H, Françot M, de Vergie S, Rigaud J, Chapuis M, Brureau L, Jousseaume C, Karray O, Kosseifi FT, Borojeni S, Descazeaud A, Asare HJ, Gaullier M, Poussot B, Tricard T, Baboudjian M, Lechevallier É, Delpech PO, Ducousso H, Bernardeau S, Bruyère F, Vallée M. Asymptomatic bacteriuria prior to partial and radical nephrectomy: To screen or not to screen? Results from the national and multicenter TOCUS database. World J Urol 2024; 42:179. [PMID: 38507063 DOI: 10.1007/s00345-024-04853-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 02/06/2024] [Indexed: 03/22/2024] Open
Abstract
INTRODUCTION In the era of increased bacterial resistance, the main strategy is to reduce the prescription of antibiotics when possible. Nowadays, it is highly recommended to screen for asymptomatic bacteriuria (ABU), prior to urological surgery with potential mucosal breach or urine exposure. Screening and treating urinary colonization is a strategy widely adopted before radical and partial nephrectomy but without any evidence. Our main end point in this study is to analyze the relationship between preoperative urine culture and the risk of postoperative febrile urinary tract infection (UTI) or surgical-site infection (SSI) in partial or radical nephrectomy patients. METHODS We conducted a multicenter retrospective cohort study between January 2016 and January 2023 in 11 French tertiary referral hospitals (TOCUS database). We collected the data for 269 patients including several pre-, intra-, and post-operative variables that could potentially increase the risk of postoperative UTI and SSI including preoperative urinary culture results. RESULTS The incidence rate of postoperative UTI and SSI was 8.9% in our study. After conducting a logistic multivariate analysis, a propensity score matching analysis, and a subgroup analysis, we found no significant correlation between the urine culture and the postoperative UTI risk [OR = 1.2 (0.5-2.7) (p = 0.7)]. Only the postoperative non-infectious complications were related to a higher risk of postoperative UTI [OR = 12 (4-37), p < 0.001)]. CONCLUSION Our research shows that screening and treating for ABU prior to radical or partial nephrectomy seems to be unnecessary to prevent postoperative UTI and SSI.
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Affiliation(s)
- Elias Ayoub
- Département d'urologie et de transplantation rénale, Centre Hospitalier Universitaire, 2 rue de la Milétrie, 86000, Poitiers, France.
| | - Stessy Kutchukian
- Département d'urologie et de transplantation rénale, Centre Hospitalier Universitaire, 2 rue de la Milétrie, 86000, Poitiers, France
| | - Pierre Bigot
- Département d'urologie Centre Hospitalier Universitaire, Angers, France
| | - Aurélien Dinh
- Service de maladies infectieuses, Centre Hospitalier Universitaire, R. Poincaré, APHP, GarchesUniversité Versailles Paris Saclay, IHU PROMETHEUS, Paris, France
- Membre du comité d'infectiologie de l'Association Française d'Urologie (CIAFU), Paris, France
| | - Bastien Gondran-Tellier
- Département d'urologie Centre Hospitalier Universitaire, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Humphrey Robin
- Département d'urologie et de transplantation rénale, Centre Hospitalier Universitaire, 2 rue de la Milétrie, 86000, Poitiers, France
| | - Marc Françot
- Département d'urologie Centre Hospitalier Universitaire, Nantes, France
| | | | - Jérôme Rigaud
- Département d'urologie Centre Hospitalier Universitaire, Nantes, France
| | - Mathilde Chapuis
- Département d'urologie Centre Hospitalier Universitaire, Guadeloupe, France
| | - Laurent Brureau
- Département d'urologie Centre Hospitalier Universitaire, Guadeloupe, France
| | - Camille Jousseaume
- Département d'urologie et de transplantation rénale, Centre Hospitalier Universitaire, 2 rue de la Milétrie, 86000, Poitiers, France
| | - Omar Karray
- Département d'urologie Centre Hospitalier, Pontoise, France
| | - Fares T Kosseifi
- Département d'urologie Centre Hospitalier Universitaire, Paris Saint Joseph, France
| | - Shahed Borojeni
- Département d'urologie Centre Hospitalier Universitaire, Paris Saint Joseph, France
| | | | - Harrison-Junior Asare
- Département d'urologie et de transplantation rénale, Centre Hospitalier Universitaire, 2 rue de la Milétrie, 86000, Poitiers, France
| | - Maxime Gaullier
- Département d'urologie Centre Hospitalier Universitaire, Strasbourg, France
| | - Baptiste Poussot
- Département d'urologie Centre Hospitalier Universitaire, Strasbourg, France
| | - Thibault Tricard
- Département d'urologie Centre Hospitalier Universitaire, Strasbourg, France
| | - Michael Baboudjian
- Département d'urologie Centre Hospitalier Universitaire, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Éric Lechevallier
- Département d'urologie Centre Hospitalier Universitaire, Aix-Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Pierre-Olivier Delpech
- Département d'urologie et de transplantation rénale, Centre Hospitalier Universitaire, 2 rue de la Milétrie, 86000, Poitiers, France
| | - Héloïse Ducousso
- Département d'urologie et de transplantation rénale, Centre Hospitalier Universitaire, 2 rue de la Milétrie, 86000, Poitiers, France
| | - Simon Bernardeau
- Département d'urologie et de transplantation rénale, Centre Hospitalier Universitaire, 2 rue de la Milétrie, 86000, Poitiers, France
| | - Franck Bruyère
- Membre du comité d'infectiologie de l'Association Française d'Urologie (CIAFU), Paris, France
- Département d'urologie Centre Hospitalier Universitaire, Tours, France
| | - Maxime Vallée
- Département d'urologie et de transplantation rénale, Centre Hospitalier Universitaire, 2 rue de la Milétrie, 86000, Poitiers, France
- Membre du comité d'infectiologie de l'Association Française d'Urologie (CIAFU), Paris, France
- Université de Poitiers, unité INSERM U1070, PHAR2, 86000, Poitiers, France
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Peyronnet B, Cornu JN, Belas O, Capon G, Biardeau X, Lecoanet P, Castro-Sader L, Borojeni S, Hein R, Hascoet J, Thibault F, Dubois F, Cardot V, Vidart A, Descazeaud A, Fournier G, Van Der Aa F. Robot-assisted artificial urinary sphincter implantation in female patients: An international multicenter series of 182 patients. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00658-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Stessy K, Robin H, Bigot P, Baboudjian M, Françot M, De Vergie S, Rigaud J, Chapuis M, Brureau L, Jousseaume C, Karray O, Kosseifi F, Borojeni S, Lechevallier E, Bernardeau S, Bruyère F, Gondran-Tellier B, Vallée M. Epidemiology of asymptomatic bacteriuria prior urological surgery: preliminary results of the retrospective and multicenter TOCUS study. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00121-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Brureau L, Chapuis M, Robin H, Bigot P, Baboudjian M, Françot M, De Vergie S, Rigaud J, Jousseaume C, Karray O, Kosseifi F, Borojeni S, Lechevallier E, Bernardeau S, Gondran-Tellier B, Bruyère F, Kutchukian S, Vallée M. Risk factors of infectious complications after benign prostatic hyperplasia surgery: Preliminary results from the retrospective and multicenter TOCUS cohort. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00200-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Stessy K, Robin H, Bigot P, Baboudjian M, Françot M, De Vergie S, Rigaud J, Chapuis M, Brureau L, Jousseaume C, Karray O, Kosseifi F, Borojeni S, Lechevallier E, Bernardeau S, Bruyère F, Gondran-Tellier B, Vallée M. Risk factors for postoperative infections after urological surgery: Preliminary results from the national and multicenter TOCUS study. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00202-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Robin H, Kutchukian S, Bigot P, Françot M, Devergie S, Rigaud J, Chapuis M, Brureau L, Kosseifi F, Borojeni S, Badoudjian M, Lechevallier E, Gondran-tellier B, Vallée M. Tocus : la durée de traitement antibiotique d’une colonisation urinaire préopératoire en chirurgie urologique influence-t-elle la survenue de complications infectieuses postopératoires ? Prog Urol 2021. [DOI: 10.1016/j.purol.2021.08.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Chapuis M, Kutchukian S, Gondran-tellier B, Robin H, Bigot P, Francot M, De vergie S, Rigaud J, Kosseifi F, Borojeni S, Baboudjian M, Lechevallier E, Vallée M, Brureau L. Évaluation des facteurs de risque infectieux de la chirurgie de l’hypertrophie bénigne de la prostate : étude multicentrique Tocus. Prog Urol 2021. [DOI: 10.1016/j.purol.2021.08.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kutchukian S, Robin H, Baboudjian M, Kosseifi F, Borojeni S, Francot M, Lechevallier E, Gondran Tellier B, Vallée M. Étude multicentrique et rétrospective évaluant l’impact des modalités de traitement antibiotique de la colonisation urinaire avant chirurgie urologique. Résultats préliminaires de l’étude TOCUS. Infect Dis Now 2021. [DOI: 10.1016/j.idnow.2021.06.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Borojeni S, Borojeni A, Panayotopoulos P, Bouvier A, Aubé C, Azzouzi AR, Bigot P. Study of Renal and Kidney Tumor Vascularization Using Data from Preoperative Three-dimensional Arteriography Prior to Partial Nephrectomy. Eur Urol Focus 2020; 6:112-121. [PMID: 30078544 DOI: 10.1016/j.euf.2018.07.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 06/24/2018] [Accepted: 07/18/2018] [Indexed: 01/20/2023]
Abstract
BACKGROUND In a cadaveric model with healthy kidneys, it has recently been highlighted that a single renal segment could be supplied by one or more arterial branches originating from an artery supplying another segment. OBJECTIVE To demonstrate occurrences of anatomical variations of renal vascularization and to analyze vascularization of renal tumors. DESIGN, SETTING, AND PARTICIPANTS This prospective monocentric study included all patients treated for a renal tumor between May 2015 and June 2017 by laparoscopic partial nephrectomy after superselective tumor embolization in a hybrid operating room. INTERVENTION Three-dimensional renal and tumoral arteriography with cone-beam computed tomography scan was performed, coupled with preoperative cross-sectional imaging. This procedure provided an accurate vascular anatomical mapping of the kidney and allowed further analysis of tumor vascularization. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Relation between anatomical variations of the vascularization and perioperative data was assessed. A χ2 test or Fisher's test was used for qualitative variables, and a Student t test was used for quantitative variables. RESULTS AND LIMITATIONS Out of the 60 patients included, only 25 (42%) presented a standard vascular subdivision. In 26 patients (43%), tumors were supplied by more than one branch and in 20 patients (33%), there was a branch supplying the tumor from another segment. In these cases of multiple or multi-segmental tumor vascularization, tumor size, operative duration, and duration of embolization were significantly higher than in the case of standard vascularization. These complex tumors were more often located at the upper pole of the kidney or at the junction of the anterior and posterior vascular territories of the kidney. Limitations of this study include the low number of patients and its monocentricity. CONCLUSIONS This study confirms that renal vascularization frequently differs from Graves' reference model and that tumor vascularization can depend on several segmental branches. This vascular complexity explains surgical difficulties and must be taken into consideration when segmental arterial clamping is considered during partial nephrectomy. PATIENT SUMMARY We studied renal and tumor vascularization using three-dimensional preoperative arteriography data on tumor kidneys. We have shown that there is great variability in renal vascularization and that tumors can be vascularized branches that originate from an artery leading to another segment. This vascular complexity explains surgical difficulties and must be taken into consideration when segmental arterial clamping is considered during partial nephrectomy.
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Affiliation(s)
- Shahed Borojeni
- Urology Department, Angers University Hospital, Angers, France
| | | | | | - Antoine Bouvier
- Radiology Department, Angers University Hospital, Angers, France
| | - Christophe Aubé
- Radiology Department, Angers University Hospital, Angers, France
| | | | - Pierre Bigot
- Urology Department, Angers University Hospital, Angers, France.
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Madec FX, Borojeni S. [Diabetes and erectile dysfunction]. Rev Prat 2019; 69:e316. [PMID: 32237639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
| | - Shahed Borojeni
- Service d'urologie, groupe hospitalier Paris-Saint-Joseph, 75014 Paris, France
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Madec FX, Borojeni S. [Erectile dysfunction]. Rev Prat 2019; 69:e307-e315. [PMID: 32237638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
| | - Shahed Borojeni
- Service d'urologie, groupe hospitalier Paris-Saint-Joseph, 75014 Paris, France
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Bracchitta D, Costa P, Borojeni S, Ménard J, Bryckaert PE, Mandron É. Laparoscopic artificial urinary sphincter implantation in women with stress urinary incontinence: update on 13 years’ experience in a single centre. BJU Int 2019; 123:E14-E19. [DOI: 10.1111/bju.14653] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Damiano Bracchitta
- Department of Urology; Clinique du Pré; Technopôle Université; Le Mans France
- Division of Urology; Department of Translational Research; University of Pisa; Pisa Italy
| | - Pedro Costa
- Department of Urology; Clinique du Pré; Technopôle Université; Le Mans France
- Centro Hospitalar de Vila Nova de Gaia/Espinho; Angers Portugal
| | - Shahed Borojeni
- Department of Urology; Clinique du Pré; Technopôle Université; Le Mans France
| | - Johann Ménard
- Department of Urology; Clinique du Pré; Technopôle Université; Le Mans France
| | | | - Éric Mandron
- Department of Urology; Clinique du Pré; Technopôle Université; Le Mans France
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Borojeni S, Rizk J, Corno L, Gaudillat C, Fizazi K, Baumert H. Néphrectomie partielle pour tumeur rénale complexe. Prog Urol 2018. [DOI: 10.1016/j.purol.2018.07.250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Corbery B, Lebdai S, Borojeni S, Bigot P, Azzouzi AR, Culty T. Mesalazine: A Novel Etiology For Drug-Induced Urinary Calculi. Urol J 2018; 15:132-133. [PMID: 29277882 DOI: 10.22037/uj.v0i0.3902] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
We report the case of a 23-year-old woman treated by mesalazine for ulcerative colitis and who subsequently presented recurrent renal colic due to mesalazine urinary stones. This is the second case described in the literature.Mesalazine stones are soft, friable and have an orange-beige color. They are not visible on non-contrast computed tomography (CT). Their diagnosis is based on morpho-constitutional analysis and CT-urography. Patients treatedby mesalazine who present renal colic should undergo CT-urography in order to make the diagnosis.
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Affiliation(s)
- Blaise Corbery
- Department of Urology, Angers University Hospital, Angers, France.
| | - Souhil Lebdai
- Department of Urology, Angers University Hospital, Angers, France
| | - Shahed Borojeni
- Department of Urology, Angers University Hospital, Angers, France
| | - Pierre Bigot
- Department of Urology, Angers University Hospital, Angers, France
| | | | - Thibaut Culty
- Department of Urology, Angers University Hospital, Angers, France
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Borojeni S, Borojeni A, Panayotopoulos P, Bouvier A, Azzouzi AR, Bigot P. PD07-03 STUDY OF RENAL AND KIDNEY TUMOR VASCULARIZATION USING DATA FROM PREOPERATIVE THREE-DIMENSIONAL ARTERIOGRAPHY BEFORE PARTIAL NEPHRECTOMY. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Borojeni S, Bigot P, Azzouzi A, Bouvier A, Panayotopoulos P. Étude la vascularisation rénale et des tumeurs rénales à partir des données d’artériographies tridimensionnelles préopératoires. Prog Urol 2017. [DOI: 10.1016/j.purol.2017.07.187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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