Risk factors for postoperative urinary tract infection following midurethral sling procedures

• Published in: European journal of obstetrics & gynecology and reproductive biology 2017-04, Vol.211, p.74-77
• Main Authors: Doganay, Melike, Cavkaytar, Sabri, Kokanali, Mahmut Kuntay, Ozer, Irfan, Aksakal, Orhan Seyfi, Erkaya, Salim
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Aged; Female; Humans; Middle Aged; Midurethral sling; Obstetrics and Gynecology; Postoperative Complications - etiology; Risk Factors; Suburethral Slings - adverse effects; Urinary Incontinence, Stress - surgery; Urinary tract infection; Urinary Tract Infections - etiology; Urologic Surgical Procedures - adverse effects
• ISSN: 0301-2115; 1872-7654
• DOI: 10.1016/j.ejogrb.2017.02.006

Abstract Objective To identify the potential risk factors for urinary tract infections following midurethral sling procedures. Study design 556 women who underwent midurethral sling procedure due to stress urinary incontinence over a four-year period were reviewed in this retrospective study. Of the study population, 280 women underwent TVT procedures and 276 women underwent TOT procedures. Patients were evaluated at 4–8 weeks postoperatively and were investigated for the occurrence of a urinary tract infection. Patients who experienced urinary tract infection were defined as cases, and patients who didn’t were defined as controls. All data were collected from medical records. Multivariate logistic regression model was used to identify the risk factors for urinary tract infection. Results Of 556 women, 58 (10.4%) were defined as cases while 498 (89.6%) were controls. The mean age of women in cases (57.8 ± 12.9 years) was significantly greater than in controls (51.8 ± 11.2 years) (p < 0.001). The presence of menopausal status, previous abdominal surgery, preoperative antibiotic treatment due to urinary tract infection, concomitant vaginal hysterectomy and cystocele repair, TVT procedure and postoperative postvoiding residual bladder volume ≥100 ml were more common in cases than in controls. However, in multivariate regression analysis model presence of preoperative urinary tract infection [OR (95% CI) = 0.1 (0.1–0.7); p = 0.013], TVT procedure [OR (95% CI) = 8.4 (3.1–22.3); p = 0.000] and postoperative postvoiding residual bladder volume ≥100 ml [OR (95% CI) = 4.6 (1.1–19.2); p = 0.036] were significant independent risk factors for urinary tract infection following midurethral slings Conclusion Urinary tract infection after midurethral sling procedures is a relatively common complication. The presence of preoperative urinary tract infection, TVT procedure and postoperative postvoiding residual bladder volume ≥100 ml may increase the risk of this complication. Identification of these factors could help surgeons to minimize this complicationby developing effective strategies.