ORIGINAL PAPER
Post-cystoscopic urinary tract infection in infants: assessing risk factors and prophylactic efficacy
 
More details
Hide details
1
Department of Pediatric Surgery, Urology and Traumatology, Doctoral School, Poznan University of Medical Sciences, Poznan, Poland
 
2
Department of Pediatric Surgery, Urology and Traumatology, Karol Jonscher University Hospital, Poznan, Poland
 
3
Department of Pediatric Surgery, Medical University of Warsaw, Warsaw, Poland
 
 
Submission date: 2026-01-17
 
 
Final revision date: 2026-05-11
 
 
Acceptance date: 2026-05-12
 
 
Publication date: 2026-10-08
 
 
Corresponding author
Ewa Joanna Bucko   

Uniwersytet Medyczny imienia Karola Marcinkowskiego w Poznaniu, Klinika Chirurgii, Urologii i Traumatologii Dziecięcej, Szkoła Doktorska
 
 
Pediatr Pol 2026;101(3):247-251
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Cystoscopy is a common diagnostic and therapeutic procedure in the pediatric population. However, the incidence of post-cystoscopic urinary tract infection (pcUTI) remains largely unexamined. This study evaluates the role of urinalysis and a history of previous urinary tract infection (UTI) as potential risk factors for pcUTI. It also analyzes the efficiency of the antibiotic treatment as prophylaxis for pcUTI.

Material and methods:
We conducted a retrospective analysis of the medical records of infants who underwent cystoscopic procedures at the Pediatric Surgery Department in Poznan between 2020 and 2024. The occurrence of post-cystoscopic UTI was recorded within 14 days after the procedure. Statistical analysis was performed using Statistica v.13.0.

Results:
A total of 115 patients were analyzed (82% male, 18% female; median age: 5 months). A history of previous UTI was present in 29% of patients. Preprocedural urinalysis indicated signs of UTI in 21% of patients, of whom 67% received additional antibiotic treatment. Perioperative furazidine was administered to 57% of patients. Post-cystoscopic urinary tract infection occurred in 18 cases (17%). There was no statistically significant association between the occurrence of pcUTI and a positive history of UTI or urinalysis findings suggestive of UTI prior to cystoscopy, regardless of additional antibiotic treatment. Similarly, no statistically significant difference was observed between patients who received perioperative furazidine and those who received perioperative antibiotics.

Conclusions:
Preoperative urinalysis is not a sufficient predictor of the post-cystoscopic UTI risk. History of previous UTI is also insufficient as a predictor of pcUTI. Neither perioperative furazidine nor antibiotic therapy appears to be effective in preventing pcUTI in infants. Further studies are necessary for standardizing the indications and methods of prophylaxis.
REFERENCES (31)
1.
Johnson DK, Kroovand RL, Perlmutter AD. The changing role of cystoscopy in the pediatric patient. J Urol 1980; 123: 232-233.
 
2.
Arena S, Russo T, Perrone P, Romeo C. Operative cystoscopy in the neonatal period. Pediatr Med Chir 2016; 38: pmc.2016.136.
 
3.
Gnech, M., A. Bujons, C. Radmayr, Hoen L, Bogaert G, Burgu B, et al. Update and summary of the EAU/ESPU paediatric guidelines on urinary tract infection in children. J Pediatr Urol 2025; 22: 105481.
 
4.
Gregg JR, Lai C, Dmochowski R, Talbot TR, Barocas DA. Recent antibiotic treatment increases the risk of urinary tract infection after outpatient cystoscopy. Urol Pract 2016; 3: 90-96.
 
5.
Seung-Hun S, Kim K. Antibiotic prophylaxis in pediatric urology. Indian J Urol 2008; 24: 145.
 
6.
Patterson LT, Strife CF. Acquired versus congenital renal scarring after childhood urinary tract infection. J Pediatr 2000; 136: 2-4.
 
7.
Wennerström M, Hansson S, Jodal U, Stokland E. Primary and acquired renal scarring in boys and girls with urinary tract infection. J Pediatr 2000; 136: 30-34.
 
8.
Finnell SME, Carroll AE, Downs SM. Diagnosis and management of an initial UTI in febrile infants and young children. Pediatric 2011; 128: e749-e770.
 
9.
Milas V, Pueljic S, Stimac M, Dobric H, Lukic G. Urinary tract infection (UTI) in newborns: risk factors, identification and prevention of consequences. Coll Anthropol 2013; 37: 871-876.
 
10.
Kim JK, Chua ME, Ming JM, Braga LH, Smith GHH, Driver C, et al. Practice variation on use of antibiotics: an international survey among pediatric urologists. J Pediatr Urol 2018; 14: 520-524.
 
11.
Kutasy B, Coyle D, Fossum M. Urinary tract infection in children: management in the era of antibiotic resistance – a pediatric urologist’s view. Eur Urol Focus 2017; 3: 207-211.
 
12.
Herr HW. Should antibiotics be given prior to outpatient cystoscopy? A plea to urologists to practice antibiotic stewardship. Eur Urol 2014; 65: 839-842.
 
13.
Herr HW. The risk of urinary tract infection after flexible cystoscopy in patients with bladder tumor who did not receive prophylactic antibiotics. J Urol 2015; 193: 548-551.
 
14.
Clark and KR, Higgs MJ. Urinary infection following out‐patient flexible cystoscopy. Br J Urol 1990; 66: 503-505.
 
15.
Tiboni SG, Bethell GS, Davidson JR, Farrugia MK. Factors influencing success in endoscopic treatment of grade 4–5 primary vesicoureteric reflux (VUR) in infancy and childhood. J Pediatr Surg 2025; 60: 162157.
 
16.
Gendron S, Sie M, Delchet O, Merol J, Garcia A, Jebbara I, et al. Impact of untreated positive urine culture on urinary tract infections after cystoscopy. Fr J Urol 2025; 35: 102840.
 
17.
Pescheloche P, Gallon J, Parier B, Bessede T, Irani J, Verrier C, et al. Faut-il contrôler la stérilité des urines avant cystoscopie en externe? Progrès Urol 2017; 27: 728-729.
 
18.
Chavarriaga J, Villanueva J, Varela D, Erazo S, Usubillaga MC, Erazo JC, et al. Do we need a urine culture before cystoscopy? Time to shift away from routine testing. Urology 2023; 172: 13-17.
 
19.
Escandón-Vargas K, García-Perdomo HA, Echeverría F, Osorio JD. Risk of urinary tract infection in patients with positive urine culture and antibiotic therapy undergoing cystoscopy in a third-level hospital. Infez Med 2015; 23: 336-342.
 
20.
Utsch B, Klaus G. Urinalysis in children and adolescents. Dtsch Ärztebl Int 2014; 111: 617-25; quiz 626.
 
21.
Yamasaki Y, Uemura O, Nagai T, Yamakawa S, Hibi Y, Yamamo- to M, et al. Pitfalls of diagnosing urinary tract infection in infants and young children. Pediatr Int 2017; 59: 786-792.
 
22.
Jackson A, Ackerman C, Alesna N, Hicks K, Tanner JP, Chang ES, et al. A retrospective cohort study to identify the risk factors for urinary tract infection after office procedures. Female Pelvic Med Reconstr Surg 2022; 28: 165-172.
 
23.
Esposito S, Rigotti E, Argentiero A, Caminiti C, Castagnola E, Lancella L, et al. Antimicrobial prophylaxis for urologic procedures in paediatric patients: a RAND/UCLA appropriateness method consensus study in Italy. Antibiotics (Basel) 2022; 11: 296.
 
24.
Dhawade P, Mulay A, Tirlapur A. POS-044 evaluation of rate and risk factors for recurrence of urinary tract infection after severe urinary tract infection needing hospitalization. Kidney Int Rep 2022; 7: S483.
 
25.
Cusumano JA, Hermenau M, Gaitanis M, Travis M, LaPlante KL, Tran TY, et al. Evaluation of post-flexible cystoscopy urinary tract infection rates. Am J Health Syst Pharmacy 2020; 77: 1852-1858.
 
26.
Snyder E, Mohan C, Michael J, Ross S. Inclusion of surgical antibiotic regimens in pediatric urology publications: a systematic review. J Pediatr Urol 202; 16: 595.e1-595.e7.
 
27.
García-Perdomo HA, López H, Carbonell J, Castillo D, Cataño JG, Serón P. Efficacy of antibiotic prophylaxis in patients undergoing cystoscopy: a randomized clinical trial. World J Urol 2013; 31: 1433-1439.
 
28.
García-Perdomo HA, Jiménez-Mejías E, López-Ramos H. Efficacy of antibiotic prophylaxis in cystoscopy to prevent urinary tract infection: a systematic review and meta-analysis. Int Braz J Urol 2015; 41: 412-424.
 
29.
Marino F, Rossi F, Murri R, Sacco E. Antibiotic prophylaxis in urologic interventions: who, when, where? Urologia 2024; 91: 11-25.
 
30.
Zeng S, Zhang Z, Bai Y, Sun Y, Xu C. Antimicrobial agents for preventing urinary tract infections in adults undergoing cystoscopy. Cochrane Database Syst Rev 2019; 2: CD012305.
 
31.
Radmayr C, Bogaert G, Bujons A, Burgu B, Castagnetti M, Hoen LA, et al. EAU guidelines on paediatric urology. Available from: https://d56bochluxqnz.cloudfro....
 
Journals System - logo
Scroll to top