Urinary tract infections after benign cystectomy: Incidence, risk factors, pathogens, and resistance patterns

Urinary tract infections (UTIs) are a known complication after cystectomy, but patients undergoing cystectomy for benign conditions represent an understudied population. This study quantified UTI rates after benign cystectomy (BC) and identified patient factors associated with infection.

We reviewed all patients who underwent BC at our institution from 2012-2025, excluding those treated for malignancy. Cystectomy type and urinary diversion were recorded. UTIs required culture confirmation of >10⁵ colony-forming units and were categorized as occurring either during the immediate postoperative period before discharge or within 90 days after discharge. Demographics and perioperative characteristics were compared between patients with and without UTIs in each time frame.

Among 183 patients undergoing BC, 27 (14.8%) developed an immediate postoperative UTI, and 35 (19.1%) developed a UTI within 90 days. Sixty patients (32.8%) received postoperative antibiotic prophylaxis (AP). AP was not associated with lower rates of immediate postoperative UTIs, and patients who developed a UTI within 90 days were more likely to have received AP (55.9% vs. 28.1%; p<0.05). Common pathogens included Enterococcus species, Escherichia coli, and Klebsiella pneumoniae. Patients with immediate postoperative UTIs had longer operative times (390 minutes vs. 340 minutes; p<0.05). Those with UTIs within 90 days were more frequently readmitted (94.3% vs. 26.1%; p<0.05).

UTIs after BC are common both immediately postoperatively and within 90 days. AP did not reduce early UTIs and were associated with higher 90-day UTI rates. Further investigation is warranted to clarify risk factors and optimize prevention strategies.