[Postoperative bacteriuria and urinary tract infections in gynecological patients]

This prospective study was carried out to establish the risk of postoperative asymptomatic bacteriuria developing into a symptomatic urinary tract infection if left untreated. Among 454 women who underwent routine gynaecological surgery using transurethral catheters for a mean of 1.4 days, 243 (53.5%) had postoperative bacteriuria and 74 (16.3%) developed urinary tract infection. Positive urine cultures showed a low predictive value for infection, even when combined with the presence of pyuria. Among 174 women discharged with asymptomatic bacteriuria, 36 (20.7%) developed urinary tract infection, of which all but two were caused by Gram-negative organisms or enterococci. A set of recommendations for handling postoperative bacteriuria is proposed.