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Recurrent Urinary Tract Infection After Midurethral Sling: A Retrospective Study
Jessica Hammett1, Revana Lukman, Megan Oakes
1From the *University of California Irvine, Irvine, CA, Department of Obstetrics and Gynecology †Southern California Permanente Medical Group, Irvine, CA, Department of Obstetrics and Gynecology.
Female Pelvic Medicine & Reconstructive Surgery
|July 29, 2016
Summary
Recurrent urinary tract infections (UTIs) are more common after midurethral sling (MUS) procedures. Preoperative recurrent UTIs are the only modifiable risk factor for developing them post-surgery.
Area of Science:
- Urology
- Gynecology
- Infectious Disease
Background:
- Urinary tract infections (UTIs) and recurrent UTIs (rUTIs) can occur after midurethral sling (MUS) procedures.
- Understanding the incidence and risk factors for post-MUS UTIs is crucial for patient care.
Purpose of the Study:
- To estimate the proportion of patients experiencing culture-proven UTIs and rUTIs after MUS.
- To identify risk factors associated with post-MUS UTIs.
- To compare the rates of rUTI before and after MUS.
Main Methods:
- Retrospective study of patients undergoing MUS between 2009-2012.
- Identification of patients with at least one positive urine culture (>100 K CFU/mL) within one year post-procedure.
- Analysis of procedural and diagnostic codes for MUS and UTI diagnosis.
Main Results:
- 12% of patients (883/7461) had at least one culture-proven UTI post-MUS.
- 3.5% of patients (258/7461) met the definition of recurrent UTI post-MUS.
- Patients were significantly more likely to have rUTI after MUS (29%) compared to before (10%) (P < 0.0001).
- Risk factors for post-MUS rUTI included Caucasian and African-American ethnicity, older age, and a history of rUTI.
Conclusions:
- Postoperative recurrent UTI is a significant concern following midurethral sling procedures.
- Preoperative recurrent UTI is the sole modifiable risk factor identified for increased risk of postoperative recurrent UTI.
