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Treatment for Urinary Tract Infection After Midurethral Sling: A Retrospective Study Comparing Patients Who Receive Short-Term Postoperative Catheterization and Patients Who Pass a Void Trial on the Day of Surgery

Dieter, Alexis A. MD; Amundsen, Cindy L. MD; Visco, Anthony G. MD; Siddiqui, Nazema Y. MD, MHSc

Female Pelvic Medicine & Reconstructive Surgery: May/June 2012 - Volume 18 - Issue 3 - p 175–178
doi: 10.1097/SPV.0b013e3182544e03
Original Articles

Introduction: This is a retrospective cohort study comparing the risk of treatment for postoperative urinary tract infection (UTI) in patients who receive short-term postoperative catheterization versus those who pass a void trial on the day of surgery after midurethral sling with or without concomitant pelvic surgery.

Materials and Methods: We compared two cohorts to determine our primary outcome: treatment for UTI, culture proven or empiric, within three weeks after surgery.

Results: 138 patients, were included in the study of which 80 (58%) received postoperative catheterization. The baseline characteristics of the catheterized and noncatheterized groups were similar except that the catheterized group had a lower mean body mass index (28 ± 5 vs 30 ± 5 kg/m2; P = 0.01), were more likely to have undergone concomitant pelvic surgery (51% vs 20%; P < 0.01), had higher estimated blood loss (92 ± 87 vs 47 ± 49 mL; P < 0.01), and had longer operative times (108 ± 75 vs 62 ± 47 min; P < 0.01). Overall, 19.6% of the patients received treatment for UTI. Patients in the catheterized group were more likely to receive treatment for UTI (24/80 [30%] catheterized vs 3/58 [5%] noncatheterized; P < 0.01). This significant difference in treatment for UTI persisted when examining patients who underwent midurethral sling only without concomitant pelvic surgery (6/29 [20.7%] catheterized vs 1/38 [2.6%] noncatheterized; P = 0.04). In a logistic regression model adjusting for age, body mass index, concomitant surgery, and postoperative catheterization, only postoperative catheterization remained significantly associated with treatment for UTI (OR, 6.6; 95% confidence interval, 1.8–24.5; P < 0.01).

Conclusions: Treatment for postoperative UTI is significantly higher in patients who receive short-term postoperative catheterization after midurethral sling with or without concomitant pelvic surgery.

This is a retrospective cohort study of patients undergoing midurethral sling with or without concomitant pelvic surgery comparing the risk of treatment of UTI in patients receiving short-term postoperative catheterization compared to patients who pass a void trial on the day of surgery.

From the Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC.

Reprints: Alexis A. Dieter, MD, Duke University Medical Center, Box 3616, Durham, NC 27710. E-mail: alexis.dieter@duke.edu.

No funds were received for this research. The authors do not have any associations (commercial or otherwise) that pose a conflict of interest with the submitted material.

© 2012 by Wolters Kluwer Health | Lippincott Williams & Wilkins