Incidence of and Risk Factors for Postoperative Urinary Tract Infection After Abdominal and Vaginal Colpopexy

Abstract

Objective The aims of the study were to determine the rate of urinary tract infection (UTI) in women undergoing colpopexy and to evaluate risk factors and timing for postoperative UTI. Methods This was a retrospective cohort study using the American College of Surgeons National Surgical Quality Improvement Program database from 2010 to 2017. Patients were grouped into those with and without UTI. Pairwise analysis between groups was performed using χ2 and Fisher exact test. Multivariable logistic regression was used to identify independent predictors of UTI. Results Of 23,097 women who underwent colpopexy, 1079 (4.7%) experienced a postoperative UTI. Urinary tract infection was most frequently diagnosed in the second week after surgery (38.2%), compared with week 1 (19.9%), 3 (22.8%), and 4 (19.1%) (P < 0.001). Patients diagnosed with a UTI were more likely to have insulin-dependent diabetes (2.8% vs 1.7%, P = 0.006), coagulopathy (1.3% vs 0.7%, P = 0.04), and chronic steroid use (2.7% vs 1.8%, P = 0.004). Patients with a UTI versus those without a UTI were more likely to have undergone an intraperitoneal or extraperitoneal vaginal colpopexy (37.8% vs 30.5%, P < 0.001) and (29.8% vs 25.6%, P = 0.003), respectively, and more likely to undergo combined anterior and posterior colporrhaphy (17.1% vs 12.2%, P < 0.001). After logistic regression, intraoperative cystotomy repair (adjusted odds ratio = 2.93, 95% confidence interval = 1.54–5.59) was the most significant risk factor. Conclusions Postoperative UTI after colpopexy occurred less frequently than previously reported. Vaginal colpopexy is associated with a higher risk of UTI than abdominal or laparoscopic colpopexy.

Methenamine Hippurate With Cranberry Capsules Versus Cranberry Alone for Urinary Tract Infection Prevention in a Short-Term Indwelling Foley Catheter Population After Urogynecologic Surgery: A Double-Blinded Randomized Controlled Trial

“…Furthermore, the previous studies define UTI based on symptoms with positive culture, thus contributing to a lower incidence of UTI compared with our study. Therefore, when re-evaluating our UTI incidence based on symptoms with a positive culture, our rate reaches 30% within 6 weeks of surgery, which is similar to cited results among the postoperative gynecological surgery population 5,19,30 …”

“…Among women undergoing pelvic reconstructive surgery, the prevalence of postoperative urinary tract infection (UTI) ranges from 10% to 76% 1,2 . Risk factors in this population are many, including age and medical comorbidity 2–5 . Furthermore, postoperative urinary retention may occur in up to 43%, resulting in some form of catheterization 6–8 .…”

“…Furthermore, postoperative urinary retention may occur in up to 43%, resulting in some form of catheterization 6–8 . As a result, readmission, morbidity, and mortality rates related to these infections are high 5 …”

“…1,2 Risk factors in this population are many, including age and medical comorbidity. [2][3][4][5] Furthermore, postoperative urinary retention may occur in up to 43%, resulting in some form of catheterization. [6][7][8] As a result, readmission, morbidity, and mortality rates related to these infections are high.…”

“…[6][7][8] As a result, readmission, morbidity, and mortality rates related to these infections are high. 5 Over the years, various agents have been proposed to help reduce rates of UTI; however, there is no clear consensus. Because of antimicrobial resistant bacteria, the Infectious Disease Society of America recommends against prophylactic antibiotic use in patients with short-and long-term catheterization.…”