{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T01:00:15Z","timestamp":1793322015902,"version":"4.5.0"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,2,27]],"date-time":"2020-02-27T00:00:00Z","timestamp":1582761600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,2,27]],"date-time":"2020-02-27T00:00:00Z","timestamp":1582761600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Office cystoscopy may be associated with urinary tract infection (UTI) in up to 10\u201320% of patients. Current practice of surgical part preparation in males with povidone-iodine excludes distal urethra in males, leaving a possibility for resident intra-urethral flora to cause post-procedural UTI. We designed this randomized study to assess whether additional cleaning of distal urethra with povidone-iodine solution can help reduce post-procedural incidence of UTIs in this setting. Additionally, urethral swab culture was done in the entire cohort to identify the prevalent microflora in the distal male urethra and to evaluate its role in causation of post-procedural UTI. Using a specialized urethral swab culture methodology, 85% males demonstrated some bacteria and 16% showed common uro-pathogens. 28 (14.5%) cases had post-procedure culture positive UTI. The incidence of UTI in control group (22%) was significantly more than the intervention group (7%) (p value &lt;0.007). This result strongly supports inclusion of distal urethral irrigation with povidone-iodine in males before office cystoscopy, even when pre-procedure mid-stream urine culture is sterile.<\/jats:p>","DOI":"10.1038\/s41598-020-60522-4","type":"journal-article","created":{"date-parts":[[2020,2,27]],"date-time":"2020-02-27T11:04:32Z","timestamp":1582801472000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Urethral Instillation of Povidone-Iodine Reduces Post-Cystoscopy Urinary Tract Infection in Males: A Randomized Controlled Trial"],"prefix":"10.1038","volume":"10","author":[{"given":"Rishi","family":"Nayyar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohit","family":"Dadhwal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arti","family":"Kapil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravindra Mohan","family":"Pandey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"PremNath","family":"Dogra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,2,27]]},"reference":[{"key":"60522_CR1","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1111\/j.1464-410X.1990.tb14997.x","volume":"66","author":"KR Clark","year":"1990","unstructured":"Clark, K. R. & Higgs, M. L. Urinary infection following out-patient flexible cystoscopy. Br. J. Urol. 66, 503 (1990).","journal-title":"Br. J. Urol."},{"key":"60522_CR2","unstructured":"Wolf, J. S. et al. Best Practice Statement on Urologic Surgery Antimicrobial Prophylaxis (Updated 2014). Linthicum: American Urological Association; 26e29 (2014)."},{"key":"60522_CR3","unstructured":"Cohen, M. S., Weber, R. D. & Mardh, P. A. Genitourinary mucosal defenses, in Holmes, K.K. et al. (Eds): Sexually Transmitted Diseases. 117\u2013127. (New York, McGraw-Hill, 1990)."},{"key":"60522_CR4","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1038\/nri2272","volume":"8","author":"MN Starnbach","year":"2008","unstructured":"Starnbach, M. N. & Roan, N. R. Conquering sexually transmitted diseases. Nat. Rev. Immunol. 8, 313\u2013317 (2008).","journal-title":"Nat. Rev. Immunol."},{"key":"60522_CR5","doi-asserted-by":"publisher","first-page":"e14116","DOI":"10.1371\/journal.pone.0014116","volume":"5","author":"DE Nelson","year":"2010","unstructured":"Nelson, D. E. et al. Characteristic male urine microbiomes associate with asymptomatic sexually transmitted infection. Plos One. 5, e14116 (2010).","journal-title":"Plos One."},{"key":"60522_CR6","doi-asserted-by":"publisher","first-page":"e19709","DOI":"10.1371\/journal.pone.0019709","volume":"6","author":"Q Dong","year":"2011","unstructured":"Dong, Q. et al. The microbial communities in male first catch urine are highly similar to those in paired urethral swab specimens. Plos One. 6, e19709 (2011).","journal-title":"Plos One."},{"key":"60522_CR7","doi-asserted-by":"publisher","first-page":"e8422","DOI":"10.1371\/journal.pone.0008422","volume":"5","author":"LB Price","year":"2010","unstructured":"Price, L. B. et al. The effects of circumcision on the penis microbiome. Plos One. 5, e8422 (2010).","journal-title":"Plos One."},{"key":"60522_CR8","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1128\/jcm.6.5.482-488.1977","volume":"6","author":"WR Bowie","year":"1977","unstructured":"Bowie, W. R. et al. Bacteriology of the urethra in normal men and men with nongonococcal urethritis. J. Clin. Microbiol. 6, 482\u2013488 (1977).","journal-title":"J. Clin. Microbiol."},{"key":"60522_CR9","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1016\/S0163-4453(85)92997-4","volume":"11","author":"TS Elliott","year":"1985","unstructured":"Elliott, T. S., Reed, L., Slack, R. C. & Bishop, M. C. Bacteriology and ultrastructure of the bladder in patients with urinary tract infections. J. Infect. 11, 191\u2013199 (1985).","journal-title":"J. Infect."},{"issue":"2","key":"60522_CR10","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1016\/S0090-4295(00)00615-4","volume":"56","author":"D MontagniniSpaine","year":"2000","unstructured":"MontagniniSpaine, D., Mamizuka, E. M., Pereira Cedenho, A. & Srougi, M. Microbiologic aerobic studies on normal male urethra. Urology. 56(2), 207\u201310 (2000).","journal-title":"Urology."},{"key":"60522_CR11","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1016\/S0090-4295(00)00615-4","volume":"56","author":"M Spaine","year":"2000","unstructured":"Spaine, M., Mamizuka, E. M., Cedenho, P. & Srougi, M. Microbiologic aerobic studies on normal male urethra. Urology. 56, 207\u201310 (2000).","journal-title":"Urology."},{"key":"60522_CR12","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1046\/j.1464-4096.2001.01899.x","volume":"89","author":"DM Burke","year":"2002","unstructured":"Burke, D. M., Shackley, D. C. & O\u2019Reilly, P. H. The community-based morbidity of flexible cystoscopy. BJU Int. 89, 347\u2013349 (2002).","journal-title":"BJU Int."},{"key":"60522_CR13","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1111\/j.1464-410X.1990.tb14997.x","volume":"66","author":"KR Clark","year":"1990","unstructured":"Clark, K. R. & Higgs, M. J. Urinary infection following out-patient flexible cystoscopy. Br. J. Urol. 66, 503\u2013505 (1990).","journal-title":"Br. J. Urol."},{"key":"60522_CR14","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/S0090-4295(00)00555-0","volume":"56","author":"YZ Almallah","year":"2000","unstructured":"Almallah, Y. Z., Rennie, C. D., Stone, J. & Lancashire, M. J. Urinary tract infection and patient satisfaction after flexible cystoscopy and urodynamic evaluation. Urology. 56, 37\u20139 (2000).","journal-title":"Urology."},{"key":"60522_CR15","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1159\/000052438","volume":"39","author":"A Ran\u00e9","year":"2001","unstructured":"Ran\u00e9, A., Cahill, D., Saleemi, A., Montgomery, B. & Palfrey, E. The issue of prophylactic antibiotics prior to flexible cystoscopy. Eur Urol. 39, 212\u20134 (2001).","journal-title":"Eur Urol."},{"key":"60522_CR16","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1177\/2051415812472678","volume":"6","author":"SP McCombie","year":"2013","unstructured":"McCombie, S. P., Carmichael, J. P., Banerjee, S. & Wood, S. J. Urinary tract infection following flexible cystoscopy: a comparison between sterilised cystoscopes and disposable sterile sheaths. J. Clin. Urol. 6, 220\u20134 (2013).","journal-title":"J. Clin. Urol."},{"issue":"1(8428)","key":"60522_CR17","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1016\/S0140-6736(85)91217-6","volume":"9","author":"PJ Van Den Broek","year":"1985","unstructured":"Van Den Broek, P. J., Daha, T. J. & Mouton, R. P. Bladder irrigation with povidone-iodine in prevention of urinary-tract infections associated with intermittent urethral catheterisation. Lancet. 9(1(8428)), 563\u20135 (1985).","journal-title":"Lancet."},{"issue":"4","key":"60522_CR18","first-page":"341","volume":"13","author":"SK Sujka","year":"1987","unstructured":"Sujka, S. K., Petrelli, N. J. & Herrera, L. Incidence of urinary tract infections in patients requiring long-term catheterization after abdominoperineal resection for rectal carcinoma: does Povidone-iodine in the Foley drainage bag make a difference? Eur. J. Surg. Oncol. 13(4), 341\u20133 (1987).","journal-title":"Eur. J. Surg. Oncol."},{"issue":"6","key":"60522_CR19","doi-asserted-by":"publisher","first-page":"917","DOI":"10.2217\/fmb.10.56","volume":"5","author":"PD Fey","year":"2010","unstructured":"Fey, P. D. & Olson, M. E. \u201cCurrent concepts in biofilm formation of Staphylococcus epidermidis\u201d. Future Microbiology. 5(6), 917\u2013933 (2010).","journal-title":"Future Microbiology."},{"key":"60522_CR20","unstructured":"Lina, G., Etienne, J. &Vandenesch F. Biology and Pathogenicity of Staphylococci other Than Staphylococcus Aureus and Staphylococcus Epidermidis,. In Fischetti, V.A.,Novick, R.P., Ferretti, J.J., Portnoy, D.A. & Rood, J.I., (eds), Gram-positive pathogens. 450\u2013462.(ASM Press, Washington, D.C.2000)."},{"issue":"8","key":"60522_CR21","doi-asserted-by":"publisher","first-page":"1592","DOI":"10.1248\/bpb.29.1592","volume":"29","author":"MC de Allori","year":"2006","unstructured":"de Allori, M. C., Jure, M. A., Romero, C. & de Castillo, M. E. Antimicrobial Resistance and Production of Biofilms in Clinical Isolates of Coagulase-Negative Staphylococcus Strains. Biol. Pharm. Bull. 29(8), 1592\u20131596 (2006).","journal-title":"Biol. Pharm. Bull."},{"issue":"4","key":"60522_CR22","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1016\/j.urols.2016.11.010","volume":"28","author":"M Nadeem","year":"2017","unstructured":"Nadeem, M., Mohammad, I. S. & Saint, M. S. Is urinary tract infection after urodynamic study predictable? Urological Science. 28(4), 240\u2013242 (2017).","journal-title":"Urological Science."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-020-60522-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-020-60522-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-020-60522-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,6]],"date-time":"2022-12-06T07:54:35Z","timestamp":1670313275000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-020-60522-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,27]]},"references-count":22,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2020,12]]}},"alternative-id":["60522"],"URL":"https:\/\/doi.org\/10.1038\/s41598-020-60522-4","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,2,27]]},"assertion":[{"value":"18 November 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 February 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 February 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"3585"}}