The Role of Intravesical 1% Povidone-iodine in Reducing Open Prostatectomy Surgical Site Infection

Povidone-iodine bladder irrigation in open prostatectomy

Abstract

Background: Surgical Site Infections following open prostatectomy are common and can account for as much as 12 - 36% of post-prostatectomy complications. This study aimed to determine the role of preoperative bladder irrigation with 1% povidone-iodine in reducing surgical site infection following open transvesical prostatectomy. Methods: A prospective randomized study over a period of eighteen months. Sixty patients who met the inclusion criteria were recruited into two groups using a computer-generated random sequence. Study group, A had bladder irrigation with 150mls of 1% povidone-iodine for 10 minutes before surgery, and Control group B had bladder irrigation for 10mins with 150mls normal saline before surgery. The patients were followed up for 30 days for signs of SSI. Results: The incidence of surgical site infections in group A was 6.7% compared to 23.3% in the control group B. There was no statistically significant difference in the surgical site infection rate between the study and control groups. (p =0.145). The overall incidence of surgical site infection was 15.0%. Escherichia coli was the most common organism isolated from the culture of infected wounds (34.0%). Surgical site infection was statistically associated with age (p=0.044); higher estimated blood loss (p=0.032) and duration of hospital stay (p < 0.001). Conclusion: There was less incidence of surgical site infection in the patients who had pre-operative 1% povidone-iodine bladder irrigation compared to controls, though the magnitude was not statistically significant. The use of 1% Povidone- iodine for pre-operative bladder irrigation in patients undergoing open transvesical prostatectomy may reduce the incidence of postoperative surgical site infection. A larger study is required to confirm the validity.