Article Figures & Data
Figures
- Fig 1.
Algorithm for evaluation of patients considered for vertebroplasty (VP). *Dysuria, urine frequency, hematuria, urgency, and suprapubic discomfort. See text for UTI symptoms in the geriatric population. †See Table 2. ‡Start treatment with trimethoprim/sulfamethoxazole 160/800 twice a day (BID) or fluoroquinolone and be guided by sensitivities obtained from urine culture. The duration of treatment is 7–14 days. §Trimethoprim/sulfamethoxazole 160/800 BID is the first-line treatment. Trimethoprim alone, fluoroquinolones for 3 days, or nitrofurantoin for 5–7 days is an alternative option. U/A indicates urine analysis; Pos., positive; Neg, negative.
Tables
- Table 1:
Spectrum of abnormal urinalysis findings in patients presenting for vertebroplasty at our institution
No. (%) Total No. of patients 30 Women 25 (83%) Average age (yr) 65.6 Positive Gram stains 17 (56.6%) Positive urine cultures 6 (20%) Positive bacteria on U/A 18 (60%) Patients treated with antibiotics 23 (76.6%) Follow-up urine after antibiotics 1 (3.3%) PV postponed due to UTI 10 (33.3%) Note:—U/A indicates urine analysis; PV, percutaneous vertebroplasty; UTI, urinary tract infection.
Complicating Factors History Diabetes Pregnancy Immunosuppressed (eg, steroids, chemotherapy) Renal calculi or renal insufficiency Known functional or structural urologic abnormalities Urinary tract catheterization (or other urologic procedure or instrumentation) within last 2 weeks Discharge from hospital or nursing home within last 2 weeks ≥4 UTIs within last 12 months Failure of TMP/SMX treatment for UTI within last 4 weeks Resident of extended-care facility Symptoms >7 Days duration Rigors (shaking chills) Flank pain: midback, severe, new, occurring with onset of these symptoms Temperature >101°F Note:—TMP indicates trimethoprim; SMX, sulfamethoxazole.
Patient population Prevalence (%) Healthy premenopausal women 1.0–5.0 Pregnant women 1.9–9.5 Postmenopausal women 50–70 years of age 2.8–8.6 Patients with diabetes Women 9.0–27 Men 0.7–11 Elderly persons in the community Women 10.8–16 Men 3.6–19 Elderly persons in a long-term-care facility Women 25–50 Men 15–40 Patients with spinal cord injuries Intermittent catheter use 23–89 Sphincterotomy and condom catheter in place 57 Patients undergoing hemodialysis 28 Patients with indwelling catheter use Short-term 9–23 Long-term 100
