Incidence and risk factors of postoperative urinary tract infection after uterosacral ligament suspension

Chung, Christopher; Kuehl, Thomas J.; Harris, Sheena K.; McBride, Madeline M.; Larsen, Wilma; Yandell, Paul M.; Shull, Bobby L.

doi:10.1007/s00192-012-1709-z

Cited by 26 publications

(14 citation statements)

References 5 publications

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“…1,2 Each year, UTIs account for more than 8.1 million visits to health care providers 3 and cost an estimated $1.6 billion in the United States alone. [5][6][7][8] The risk of UTI in this population ranges from 5% to 35% and is significantly increased with exposure to postoperative catheterization. [5][6][7][8] The risk of UTI in this population ranges from 5% to 35% and is significantly increased with exposure to postoperative catheterization.…”

Section: Resultsmentioning

confidence: 99%

“…4 In the field of obstetrics and gynecology, UTI is one of the most common complications of pelvic reconstructive surgery, as is urinary retention. 5,[7][8][9][10][11][12][13][14][15] Urinary retention occurs in up to 50% of women undergoing pelvic floor surgery. 5,[7][8][9][10][11][12][13][14][15] Urinary retention occurs in up to 50% of women undergoing pelvic floor surgery.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Oral Antibiotics to Prevent Postoperative Urinary Tract Infection

Dieter

Amundsen

Edenfield

et al. 2014

Obstetrics &Amp; Gynecology

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Oral Antibiotics to Prevent Postoperative Urinary Tract Infection

Dieter

Amundsen

Edenfield

et al. 2014

Obstetrics &Amp; Gynecology

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“…Rates of non- E.coli uropathogens have been reported in catheterized patients between 61 and 65% [16]. In a retrospective cohort of patients undergoing vaginal reconstructive surgery, prophylactic antibiotics decreased the risk of postoperative UTI in women requiring use of Foley catheterization at time of discharge [17]. This concept is further supported by Ghezzi et al [18] who reported prophylactic single-dose antibiotic therapy may help reduce the rate of UTIs after short-term urethral catheterization in women undergoing tension-free vaginal tape procedure.…”

Section: Discussionmentioning

confidence: 99%

Microbiological Analysis of Urine Cultures in Women after Pelvic Reconstructive Surgery

Dawson

Cramer²,

Thompson³

et al. 2018

Current Urology

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Background/Aims: The rate of urinary tract infection (UTI) after pelvic reconstructive surgery ranges from 9 to 48% and the most common uropathogen is Escherichia coli (E. coli). The aim of the study is to identify the predominant uro-pathogen from urine cultures in women undergoing pelvic reconstructive surgery. Methods: A retrospective review was conducted on women who underwent pelvic reconstructive surgery at a tertiary care center from July 2013 to June 2015. Data was collected from each postoperative visit to evaluate urinary tract symptoms, culture results and treatment in the 3-month postoperative interval. Results: There were 880 cases reviewed (mean age of 59.6 years) during the study period. The most common organism in positive cultures was E. coli after surgery. The total UTI rate was 11.3%. Patients discharged with a Foley catheter had a UTI rate of 65.6% (p = 0.003). Diabetes, neurologic disease, tobacco use, recurrent UTIs and breast or gynecologic cancers had no significant association with UTI after surgery. Conclusion: The most common organism identified is E. coli. Almost 12% of patients will develop a UTI after pelvic reconstructive surgery. The results of this study can influence management of lower urinary tract symptoms in the postoperative period.

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“…The incidence of UTI in these two studies was high. Urinary retention is a well‐established risk factor for UTI and the need for UTI treatment increases with duration of catheterization . Women in urinary retention who rely on catheterization for bladder‐emptying may harbor different pathogens or display higher bacterial counts.…”

Section: Discussionmentioning

confidence: 99%

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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Incidence and risk factors of postoperative urinary tract infection after uterosacral ligament suspension

Abstract: Patients requiring Foley catheter at discharge following vaginal prolapse repair are at highest risk for UTI and require prophylactic antibiotics.

Cited by 26 publications

References 5 publications

Oral Antibiotics to Prevent Postoperative Urinary Tract Infection

Oral Antibiotics to Prevent Postoperative Urinary Tract Infection

Microbiological Analysis of Urine Cultures in Women after Pelvic Reconstructive Surgery

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

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