Risk factors for urinary tract infection after midurethral sling placement
DOI:
https://doi.org/10.48193/revistamexicanadeurologa.v80i1.574Keywords:
Urinary tract infection, Recurrent urinary tract infection, Midurethral sling, Anti-incontinence surgeryAbstract
Background: Urinary tract infection (UTI) is one of the most common bacterial infections in women. UTI rates after midurethral sling (MUS) placement are as high as 34% within the first 3 postoperative months and can reach 50% at one year. The aim of the present study was to determine the frequency of UTI and its recurrence at one year from MUS placement and to identify the risk factors.
Materials and methods: A case-control study was conducted on patients that underwent MUS placement within the time frame of 2014-2017 and completed one postoperative year. They were divided into two groups: the cases that presented with UTI and the controls that did not. All variables were expressed through descriptive statistics and the two groups were compared. Odds ratio (OR) was calculated and risk adjustment was performed on the statistically significant variables. The SPSS version 25 program was employed for the statistical analysis and statistical significance was set at a p<0.05.
Results: The study was carried out on 267 patients. Thirty-four patients (12.7%) presented with UTI and 9 patients (3.4%) presented with recurrent UTI. A total of 250 TOT slings (93.6%) were placed and 17 TVT slings (6.4%). Six patients with TVT slings (35.2%) and 28 with TOT slings (11.2%) presented with UTI during the first postoperative year, with a statistically significant association. Regarding the risk factors, TVT sling placement produced an OR of 4.32 (95%CI=1.48-12.6) and the use of a urinary catheter for more than 48 hours resulted in an OR of 8.40 (95%CI=3.23-21.8).
Conclusions: The frequency of UTI and recurrent UTI after MUS placement was similar to that reported in the literature. We found TVT sling placement and the use of a urinary catheter > 48 hours to be risk factors for UTI.
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