Antibiotic Prophylaxis for Urinary Tract Infection After Midurethral Sling

Jackson, Daniel L.; Higgins, Edmund; Bracken, Jessica; Yandell, Paul M.; Shull, Bobby L.; Foster, Raymond T.

doi:10.1097/01.ogx.0000433841.18956.93

Cited by 6 publications

(15 citation statements)

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“…Overall, 37 (24.8 %) women were diagnosed with a UTI within the 6-week post-operative study period. The incidence was significantly lower in the treatment arm (17.6 %) compared to placebo (32 %), (p = 0.04) [27]. This may suggest a potential benefit to a short course of antibiotic prophylaxis but further studies are warranted.…”

Section: Immediate Post-operative Complications Urinary Tract Infectionmentioning

confidence: 87%

Evaluation and Management of Mid-Urethral Sling Complications

Brown

Cohn

Kaufman

et al. 2016

Curr Bladder Dysfunct Rep

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Currently, a mid-urethral sling is the standard of care for the treatment of female stress urinary incontinence. However, complications can occur that are unique to polypropylene mesh such as mesh exposure, perforation, or contracture. Other complications such as de novo urgency and/or urgency urinary incontinence (UUI), urinary tract infection, and/or urinary obstruction can also occur. The diagnosis of these complications requires a high index of suspicion, and treatment is critical as these complications can be quite morbid. As such, this review will discuss the most recent literature regarding the intraoperative and post-operative evaluation and management of mid-urethral sling complications.

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Section: Immediate Post-operative Complications Urinary Tract Infectionmentioning

confidence: 87%

Evaluation and Management of Mid-Urethral Sling Complications

Brown

Cohn

Kaufman

et al. 2016

Curr Bladder Dysfunct Rep

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“…Thus, during MUSs, transvaginal and transurethral transactions may lead to UTIs [8]). However, there is still no exact consensus regarding routine postoperative antibiotic treatment for these operations [8][9][10]. Identifying women who are at risk for UTI following MUS procedures may be beneficial for empirical antibiotic treatment.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for postoperative urinary tract infection following midurethral sling procedures

Doğanay

Cavkaytar

Kokanali

et al. 2017

European Journal of Obstetrics & Gynecology and Reproductiv

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“…We included four RCTs, two historical cohort studies and one before‐and‐after cohort study . The total participant number in each study ranged from 59 to 435.…”

Section: Resultsmentioning

confidence: 99%

“…Four studies included women who had vaginal surgery concomitantly with MUS. Harmanli et al, Ghezzi et al, and Swartz et al examined women with MUS alone.…”

Section: Resultsmentioning

confidence: 99%

“…Harmanli et al, Ghezzi et al, and Swartz et al examined women with MUS alone. Among studies of women with vaginal surgery concomitant with MUS, Dieter et al, Hampton et al, and Jackson et al analyzed UTI post‐MUS as a separate group; however, the studies were not powered to analyze differences in the primary outcome stratified by surgery type. Five studies included both retropubic and transobturator MUS .…”

Section: Resultsmentioning

confidence: 99%

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Urinary tract infection prevention after midurethral slings in pelvic floor reconstructive surgery: A systematic review and meta‐analysis

Sanaee

Hutcheon

Larouche

et al. 2019

Acta Obstet Gynecol Scand

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Introduction Synthetic midurethral slings are the most common procedures currently performed for stress urinary incontinence in women. Infection is a frequent complication of urogynecologic surgery. We performed a systematic review and meta‐analysis to identify interventions that successfully prevent infections, including urinary tract infection (UTI) and/or bacteriuria, compared with no intervention, in women undergoing midurethral sling surgery with or without concomitant pelvic reconstructive procedures for prolapse. Material and methods The primary outcome was the development of any infection post‐midurethral sling placement in women. MEDLINE, Embase, CINAHL and the Cochrane Library were searched for comparative studies from inception to July 2017, with no language restrictions. We used search terms related to midurethral sling, infections and infection‐reduction interventions. Two independent reviewers abstracted data and assessed study quality. Pooled effect size estimates were calculated. We conducted meta‐analysis of eligible studies. A protocol for this review has been registered and can be accessed online (http://hdl.handle.net/2429/64731). Results We identified seven eligible studies of infection risk‐reducing interventions; all focused on UTIs. Only one study assessed preoperative antibiotics with midurethral sling alone and was halted early because of low UTI rates. All other studies (three randomized control trials and three observational studies) examined whether postoperative antibiotics decrease UTI/bacteriuria rates after midurethral sling with or without reconstructive procedures for pelvic organ prolapse and using bladder catheterization postoperatively. Due to considerable clinical heterogeneity, we only combined four studies for meta‐analysis. Postoperative oral prophylactic nitrofurantoin showed no significant benefit in reducing UTI/bacteriuria in women post‐midurethral sling with or without concomitant reconstructive pelvic surgery and the need for bladder catheterization, when compared with the reference group (pooled relative risk 0.73, 95% confidence interval [CI] 0.42‐1.25). Conclusions Based on the best available evidence, postoperative oral nitrofurantoin is not effective at reducing UTI/bacteriuria rates in catheterized women after midurethral sling with or without concomitant pelvic reconstructive surgery for prolapse. For midurethral sling alone, preoperative antibiotic prophylaxis may not be needed for UTI prevention.

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Antibiotic Prophylaxis for Urinary Tract Infection After Midurethral Sling

Cited by 6 publications

References 0 publications

Evaluation and Management of Mid-Urethral Sling Complications

Evaluation and Management of Mid-Urethral Sling Complications

Risk factors for postoperative urinary tract infection following midurethral sling procedures

Urinary tract infection prevention after midurethral slings in pelvic floor reconstructive surgery: A systematic review and meta‐analysis

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