Detailed Analysis of Urinary Tract Infections After Robot-Assisted Radical Cystectomy

To describe urinary tract infections (UTIs) after robot-assisted radical cystectomy (RARC) and investigate the variables associated with it. A retrospective review of 616 patients who underwent RARC between 2005 and 2019 was performed. Patients were divided into those who developed UTI and those who did not. Patients who developed UTI were further subdivided into three subgroups according to the onset, number, and severity. The Kaplan-Meier method was used to depict time to UTI. Multivariate analysis was used to investigate variables associated with UTI. Two hundred forty (39%) patients were diagnosed with UTI after RARC; 48% occurred within 30 days, 17% within 30-90 days, and 35% at 90 days after RARC. Twenty-three percent of the patients presented with urosepsis. The median (interquartile ratio) time to develop UTI was 1 (0.3-7) month. On multivariate analysis, patients who received neobladders (odds ratio [OR] 2.80; 95% confidence interval [CI] 1.50-5.20; p < 0.01), prolonged hospital stay (OR 1.06; 95% CI 1.03-1.08; p < 0.01), adjuvant chemotherapy (OR 2.20; 95% CI 1.40-3.60; p < 0.01), poor renal function postoperatively (OR 2.30; 95% CI 1.30-3.80; p < 0.01), postoperative hydronephrosis (OR 2.50; 95% CI 1.40-4.50; p < 0.01), ureteroileal anastomotic stricture (OR 2.90; 95% CI 1.50-5.70; p < 0.01), and stented ureteroileal anastomosis (OR 9.35; 95% CI 1.23-71.19; p = 0.03) were associated with UTI after RARC. UTI is common after RARC mainly within the first month after RARC. Enterococcus faecalis was the most common causative organism.