Secondary Logo

Institutional members access full text with Ovid®

Share this article on:

Length of Catheter Use After Hysterectomy as a Risk Factor for Urinary Tract Infection

Karp, Natalie E., MD*; Kobernik, Emily K., MPH*; Kamdar, Neil S., MA*; Fore, Amanda M., RN, MS; Morgan, Daniel M., MD*

Female Pelvic Medicine & Reconstructive Surgery: November/December 2018 - Volume 24 - Issue 6 - p 430–434
doi: 10.1097/SPV.0000000000000486
Original Articles

Objectives The aims of this study were to determine the effect of length of postoperative catheterization on risk of urinary tract infection (UTI) and to identify risk factors for postoperative UTI.

Methods This was a retrospective case-control study. Demographic and perioperative data, including duration of indwelling catheter use and postoperative occurrence of UTI within 30 days of surgery, were analyzed for hysterectomies using the Michigan Surgical Quality Collaborative database. Catheter exposure was categorized as low—no catheter placed/catheter removed the day of surgery, intermediate—catheter removed postoperative day 1, high—catheter removal on postoperative day 2 or later, or highest—patient discharged home with catheter. A multivariable logistic regression model was developed to identify factors associated with UTI. An interaction term was included in the final model.

Results Overall, UTI prevalence was 2.3% and increased with duration of catheter exposure (low: 1.3% vs intermediate: 2.1% vs high: 4.1% vs highest: 6.5%, P < 0.0001). High (odds ratio [OR] = 2.54 [1.51–4.27]) and highest (OR = 3.39 [1.86–6.17]) catheter exposure, operative time (OR = 1.15 [1.03–1.29]), and dependent functional status (OR = 4.62 [1.90–11.20]) were independently associated with UTI. Women who had a vaginal hysterectomy with sling/pelvic organ prolapse repair were more likely to have a UTI than those who had a vaginal hysterectomy alone (OR = 2.58 [1.10–6.07]) and more likely to have a UTI than women having an abdominal or laparoscopic hysterectomy with a sling/pelvic organ prolapse repair (OR = 2.13 [1.12–4.04]).

Conclusions Length of catheterization and operative time are modifiable risk factors for UTI after hysterectomy. An interaction between vaginal hysterectomy and concomitant pelvic reconstruction increases the odds of UTI.

From the *Division of Gynecology, Department of Obstetrics and Gynecology; and

Office of Performance Assessment and Clinical Effectiveness, Office of Clinical Affairs, University of Michigan, Ann Arbor, MI.

Correspondence: Daniel M. Morgan, MD, Department of Obstetrics & Gynecology, Division of Gynecology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI 48109. E-mail: morgand@med.umich.edu.

Partial salary support for D.M. Morgan is provided by the Michigan Surgical Quality Collaborative.

The authors have declared they have no conflicts of interest.

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.