Abstract
OBJECTIVE: To evaluate the incidence of urinary tract infection (UTI) after combined cystoscopy and urodynamic testing. METHODS: A prospective analytical cohort study was conducted including adult patients undergoing cystoscopy, urodynamic testing, or both procedures during the same session at a quaternary referral center between May 1, 2023, and April 30, 2024. All patients were managed under an institution-wide, urine culture-guided antibiotic prophylaxis protocol. The cumulative incidence of UTI within 30 days after the procedure was calculated for the three cohorts. Sociodemographic characteristics, urodynamic parameters, and cystoscopic findings were analyzed to assess their association with UTI occurrence. RESULTS: A total of 560 patients were included, of whom 473 (84.5%) completed follow-up. Women accounted for 39.7% and men for 60.3% of the cohort, with a median age of 69 years. Seventeen patients underwent combined cystoscopy and urodynamic testing, 194 underwent urodynamic testing alone, and 262 underwent cystoscopy alone. No UTIs were observed in the combined cohort. The incidence of UTI was 2.6% following urodynamic testing and 1.9% following cystoscopy alone. No significant associations were identified between patient characteristics, urodynamic variables, or cystoscopic findings and the development of UTI. CONCLUSIONS: Combined cystoscopy and urodynamic testing do not appear to increase the risk of UTI compared with either procedure performed separately. Larger studies are required to confirm these findings and to define optimal antibiotic prophylaxis strategies and identify high-risk subgroups.