The diagnosis, epidemiology and control of urinary infection in urology and gynaecology.

In a study of the urine after urological operations, quantitative bacteriological criteria for the diagnosis of infection were determined. The bacteria responsible for urinary infection after urological or gynaecological procedures sometimes came from the same patient, but more often came from other patients by cross-infection. The principal final route of entry was the urethra or the indwelling catheter lying in it. These findings led to the elaboration of methods of destroying bacteria in the urethra before operation, improving the disinfection of cystoscopes, and preventing the entry of bacteria via the indwelling catheter. Application of these methods reduced the incidence of infection after prostatectomy from 83% to 6%, and after emergency bladder drainage for acute retention of urine from 73% to 10%. A smaller improvement followed the introduction of closed bladder drainage after gynaecological operations.