title: Treatment for urinary tract infection after midurethral sling:  a retrospective study comparing patients who receive short-term postoperative catheterization and patients who pass a void trial on the day of surgery.
abstract: BACKGROUND
  This is a retrospective cohort study comparing the risk of treatment for postoperative urinary tract infection (UTI) in patients who receive short-term postoperative catheterization versus those who pass a void trial on the day of surgery after midurethral sling with or without concomitant pelvic surgery.
  
  
  METHODS
  We compared two cohorts to determine our primary outcome: treatment for UTI, culture proven or empiric, within three weeks after surgery.
  
  
  RESULTS
  138 patients, were included in the study of which 80 (58%) received postoperative catheterization. The baseline characteristics of the catheterized and noncatheterized groups were similar except that the catheterized group had a lower mean body mass index (28 ± 5 vs 30 ± 5 kg/m(2); P = 0.01), were more likely to have undergone concomitant pelvic surgery (51% vs 20%; P < 0.01), had higher estimated blood loss (92 ± 87 vs 47 ± 49 mL; P < 0.01), and had longer operative times (108 ± 75 vs 62 ± 47 min; P < 0.01). Overall, 19.6% of the patients received treatment for UTI. Patients in the catheterized group were more likely to receive treatment for UTI (24/80 [30%] catheterized vs 3/58 [5%] noncatheterized; P < 0.01). This significant difference in treatment for UTI persisted when examining patients who underwent midurethral sling only without concomitant pelvic surgery (6/29 [20.7%] catheterized vs 1/38 [2.6%] noncatheterized; P = 0.04). In a logistic regression model adjusting for age, body mass index, concomitant surgery, and postoperative catheterization, only postoperative catheterization remained significantly associated with treatment for UTI (OR, 6.6; 95% confidence interval, 1.8-24.5; P < 0.01).
  
  
  CONCLUSIONS
  Treatment for postoperative UTI is significantly higher in patients who receive short-term postoperative catheterization after midurethral sling with or without concomitant pelvic surgery.
authors.affiliation: Department of Obstetrics and Gynecology, Duke University Medical Center, Box 3616, Durham, NC 27710, USA. alexis.dieter@duke.edu
authors.forename: Alexis A
authors.initials: AA
authors.lastname: Dieter
authors.forename: Cindy L
authors.initials: CL
authors.lastname: Amundsen
authors.forename: Anthony G
authors.initials: AG
authors.lastname: Visco
authors.forename: Nazema Y
authors.initials: NY
authors.lastname: Siddiqui
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001437:Bacteriuria / Q000188:drug therapy; D016063:Blood Loss, Surgical; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D010388:Pelvis / Q000601:surgery; D011182:Postoperative Care; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D053825:Suburethral Slings; D013997:Time Factors; D014546:Urinary Catheterization; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000209:etiology; D014554:Urination
chemical_list: D000900:Anti-Bacterial Agents