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University of Cincinnati Academic Health Center
Publish Date: 10/01/03
Media Contact: AHC Public Relations, (513) 558-4553
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UC Surgeon Has Two Papers Published in Urology Journals

Thomas Bell, MD, clinical professor, urology surgery at the UC College of Medicine, had two papers published in national journals within three months. One paper reports that a pre-biopsy Fleet enema washes away bacteria in the rectum and prevents anaerobic infection during a prostate biopsy test for cancer.  Biopsy of the prostate is necessary to accurately diagnose prostate cancer.

A prostate biopsy is done through the rectal wall, which is normally an area of high bacterial contamination. Thousands of such biopsies are done yearly and while using antibiotics to prevent infection may seem wise, no one has agreed on the antibiotic of choice, the dose or the number of days of medication.  Based on a large sample that exceeded 2000 biopsies, these researchers found that a single does of an antibiotic is efficacious and also cost effective. When applied, this practice can save millions of dollars.

"We also realized that the antibiotic we used provided only partial protection, based on the knowledge of the bacteria residing in the rectum," Dr. Bell said. "We suspect, because we saw no infection attributable to those type organisms not affected by the antibiotic, that the Fleet enema we employed just prior to the biopsy provided a significant degree of protection. In over 2000 such patients none returned with a septic infection."

The article detailing Dr. Bell's research was entitled "Patient Preparation for Transrectal Prostate Biopsy: Review of the Literature and Analysis of Cost-effectiveness appeared in the May-June 2003 issue of Infections in Urology.  This article reviewed research concerned with the effectiveness of using Fleet enemas to sanitize the rectal area in preparation for a prostate biopsy. The article also showed that lower infections equal lower costs of treatment for each patient.

Authors of the first article include:  Dennis Bentley, MD, a resident in Akron; David Kitchens, MD, a UC resident; and Dr. Bell. This was quite an extensive review and became actually the lead article. Dennis Bentley was a UC medical student several years ago. Dr. Bell was his faculty advisor in this endeavor and collaborated on this paper with him even after Dr. Bentley matched at Akron. Drs. Kitchens and Bell rewrote and edited this article numerous times since January.

"We had no idea that it would be the lead article," Dr. Bell said.

The second article entitled "Using the Gastrostomy Button as a Catheterizable Stoma in the Bladder" appeared in the September issue of the Journal of Urology.  This describes Dr. Bell's idea to use a device for which the original intent was quite different. This procedure allows patients who require self-catheterization of the urinary bladder to use this device with ease and comfort. The research was headed by Steven Bennett, MD, a resident in the teaching program. Interestingly, his wife, a nurse and current medical student co-authored the writing of the submitted manuscript.

"A husband and wife team is a little unique, but so is our residency program," Dr. Bell said.

This paper was also presented in the past year at the Ohio Urological Association annual meeting, Cincinnati Urological Society meeting, the American Urological Association (AUA) annual meeting, and the North Central Association of the AUA annual meeting. A poster presentation on the same subject was part of Ms. Bennett's research project as a second-year student.

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