Related Experiment Video
Updated: Dec 16, 2025
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Is antibiotic prophylaxis necessary in mid-urethral sling surgery?
Rune Svenningsen1,2,3, Sigurd Kulseng-Hanssen4, Ellen Bettina Casanova Kråkenes5
1Department of Gynecology, Oslo University Hospital, Ullevål, PO Box 4956 Nydalen, 0424, Oslo, Norway. RUNSVE@ous-hf.no.
Introduction And Hypothesis:
Antibiotic prophylaxis is commonly used when implanting a mid-urethral sling (MUS) for female stress urinary incontinence. Use of antibiotics may lead to adverse events and the development of antibiotic resistance. This study compared a variety of outcomes after MUS surgery with and without antibiotic prophylaxis using data from the national Norwegian Female Incontinence Registry.
Methods:
Preoperative and 6-12 months postoperative subjective and objective data from 28,687 patients who received MUS surgery from 1998 through 2017 were extracted from the registry. Categorical outcomes were compared between women with or without antibiotic prophylaxis using chi-square test for independence. Primary outcome was incidence of postoperative surgical site infection (SSI). Secondary outcomes were incidence of tape exposure, de novo or persistent urgency urinary incontinence, postoperative pain > 3 months, subjective and objective cure rates, and patient satisfaction.
Results:
Antibiotic prophylaxis was used in 9131 and not used in 19,556 patients. SSIs and prolonged postoperative pain occurred significantly more often without antibiotic prophylaxis. Subjective and objective cure rates were significantly higher and tape exposures significantly lower in women not receiving prophylactic antibiotics. There were no significant differences in other outcomes.
Conclusions:
Antibiotic prophylaxis resulted in fewer women developing postoperative infections or prolonged postoperative pain after MUS surgery, but did not offer protection against tape exposure. The differences in cure rates were small and probably without clinical relevance. If a small increase in surgical site infections is accepted, the routine use of antibiotic prophylaxis can probably be omitted.
Insights
Routine antibiotic prophylaxis for mid-urethral sling surgery may not be necessary. While it reduced infections and pain, it did not improve cure rates or reduce tape exposure, suggesting it could be omitted.
Area of Science:
- Urology
- Gynecology
- Infectious Disease
Background:
- Antibiotic prophylaxis is standard for mid-urethral sling (MUS) surgery for female stress urinary incontinence.
- Concerns exist regarding adverse events and antibiotic resistance associated with prophylactic antibiotic use.
Purpose of the Study:
- To compare outcomes of MUS surgery with and without antibiotic prophylaxis.
- To evaluate the impact of antibiotic prophylaxis on surgical site infections, pain, cure rates, and tape exposure.
Main Methods:
- Retrospective analysis of 28,687 patients from the Norwegian Female Incontinence Registry (1998-2017).
- Comparison of outcomes between women who received antibiotic prophylaxis (9,131) and those who did not (19,556).
- Statistical analysis using chi-square test for categorical outcomes.
Main Results:
- Fewer surgical site infections (SSIs) and prolonged postoperative pain were observed in the antibiotic prophylaxis group.
- Higher subjective and objective cure rates and lower tape exposure rates were found in the no-antibiotic group.
- No significant differences in other assessed outcomes, including de novo urgency or patient satisfaction.
Conclusions:
- Antibiotic prophylaxis reduced SSIs and prolonged pain but did not impact tape exposure.
- Observed differences in cure rates were minimal and likely not clinically significant.
- Routine antibiotic prophylaxis for MUS surgery may be omitted if a slight increase in SSIs is acceptable.
More Related Videos
05:32Povidone Iodine Rectal Preparation at Time of Prostate Needle Biopsy is a Simple and Reproducible Means to Reduce Risk of Procedural Infection
Published on: September 21, 2015
03:25Transcorporal Artificial Urinary Sphincter Cuff Placement in a Case Requiring Revision for Urethral Atrophy
Published on: June 16, 2022
Related Concept Videos
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
01:17Urinary Tract Infection IV: Nursing Management
01:26Urine Studies II: Urine Culture and Sensitivity Test
01:25Urinary Tract Infection II: Pathophysiology
01:25Urinary Tract Calculi VI: Surgical Management
01:26Kidney Transplant II: Surgical Procedure