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

摘要

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 T 5 vs 30 T 5 kg/m 2; P = 0.01), were more likely to have undergone concomitant pelvic surgery (51% vs 20%; P 0.01), had higher estimated blood loss (92 T 87 vs 47 T 49 mL; P 0.01), and had longer operative times (108 T 75 vs 62 T 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 associatedwith treatment forUTI (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.