Postoperative prophylactic antibiotics for retropubic mid-urethral slings

Area of Science:

• Urology
• Infectious Disease

Background:

• Urinary tract infections (UTIs) are a common complication following retropubic mid-urethral sling (RMUS) procedures.
• The efficacy of various postoperative prophylactic antibiotic regimens in preventing UTIs after RMUS placement is not well-established.

Purpose of the Study:

• To compare UTI rates within six weeks of RMUS placement across different prophylactic antibiotic strategies.
• To identify risk factors associated with postoperative UTIs.

Main Methods:

• Retrospective chart review of 112 patients undergoing RMUS (CPT code 57288) from 2014-2016.
• UTI rates determined by antibiotic prescriptions for UTI or positive urine culture.
• Univariate and logistic regression analyses were used to compare outcomes and identify risk factors.

Main Results:

• 15% of patients (17/112) developed a postoperative UTI.
• No significant difference in UTI rates was observed between patients who received prophylactic antibiotics (16%) and those who did not (14%).
• Catheterization beyond postoperative day 1 was a significant risk factor for UTI (OR 6.4, p=0.006).

Conclusions:

• Postoperative prophylactic antibiotic regimens did not significantly impact UTI rates following RMUS placement.
• Prolonged catheterization (past postoperative day 1) is a significant risk factor for developing a UTI.
• Further studies with larger sample sizes are needed to confirm these findings due to limited statistical power.