Risk factors for postoperative urinary tract infections in elderly patients with benign prostatic hyperplasia and influence on TGF-β1/Smads signaling pathways

OBJECTIVE To explore the risk factors for postoperative urinary tract infections in elderly patients with benign prostatic hyperplasia (BPH) and observe the influence on transforming growth factor beta 1(TGF-β1)/Smads signaling pathways. METHODS A total of 108 elderly patients with BPH who underwent transurethral resection of prostate (TURP) in Hainan Second People's Hospital from Sep 2018 to Sep 2020 were enrolled in the study and were divided into the infection group with 22 cases and the non-infection group with 86 cases according to the status of postoperative urinary tract infections, and the baseline clinical data of the enrolled patients were retrospectively analyzed. The distribution of pathogens, risk factors for the infections and treatment outcomes were analyzed. The peripheral blood TGF-β1/Smads signaling pathway-related indexes and inflammatory factors were detected for the two groups of patients. RESULTS Totally 24 strains of pathogens were isolated from specimens of 22 patients, among which Enterococcus faecalis and Enterococcus coli were dominant. Multivariate analysis showed that preoperative urinary retention and operation duration were the risk factors for the postoperative urinary tract infections (P＜0.05). The TGF-β1, Smad4, interleukin-1β(IL-1β), prostaglandin E2 (PGE2) and tumor necrosis factor-α (TNF-α) of the infection group were significantly higher than those of the non-infection group, while the Smad7 of the infection group was significantly lower than that of the non-infection group(P＜0.05); the TGF-β1, Smad4, IL-1β, PGE2 and TNF-α were significantly elevated with the aggravation of infections, and the Smad7 was significantly reduced(P＜0.05). The treatment outcomes were favorable after the reasonable drug administration. CONCLUSION The postoperative urinary tract infections may lead to the changes of TGF-β1/Smads signaling pathways of the TURP patients, which may be associated with the rise of serum inflammatory factors. Reasonable use of drugs and targeted interventions can facilitate favorable treatment outcomes.