AI Article Synopsis
- The study analyzed the rates and risk factors of urinary tract infections (UTIs) following hysterectomies performed for benign conditions or with pelvic reconstructive surgery.
- Out of 1,156 women, 11.8% developed a UTI within 8 weeks, with rates significantly higher (21.7%) in those undergoing combined surgeries compared to those with only benign conditions (7.3%).
- Key factors linked to increased UTI risk included being premenopausal, having anterior vaginal wall prolapse, and a high postvoid residual, emphasizing the need for preoperative assessment to predict UTI likelihood.
Article Abstract
Objective: To report rates and identify risk factors for urinary tract infection (UTI) after hysterectomy for benign conditions or combined with pelvic reconstructive surgery.
Methods: This is a cohort study that included women who underwent hysterectomy either for benign gynecologic conditions or hysterectomy combined with pelvic reconstructive surgery from January 1, 2012, through June 30, 2014, at a single institution. The primary outcome was UTI within 8 weeks of surgery. Logistic regression modeling was used to develop a model for predicting UTI after surgery.
Results: Of 1,156 women included in the study, 136 (11.8%, 95% CI 10.0-13.8) developed UTI within 8 weeks. Women who underwent hysterectomy for a benign gynecologic condition that was not combined with pelvic reconstructive surgery had an overall UTI rate of 7.3% (95% CI 5.6-9.3) vs 21.7% (95% CI 17.6-26.4) after hysterectomy combined with pelvic reconstructive surgery. After adjusting for hormone therapy use, the following were independent variables associated with postoperative UTI: premenopausal status with an adjusted odds ratio (OR) of 1.80 (95% CI 1.11-2.99), anterior vaginal wall prolapse with an adjusted OR of 4.39 (95% CI 2.77-6.97), and postvoid residual greater than 150 mL with an adjusted OR of 2.38 (95% CI 1.12-4.36). Using this model, postoperative UTI rates ranged from 4.3% to 59.4% with high postvoid residual and presence of anterior prolapse having the strongest association.
Conclusion: There are wide variations in the rate of UTI after hysterectomy for begin disease including pelvic reconstructive surgery. These variations can be explained with a model based on available preoperative data.
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| http://dx.doi.org/10.1097/AOG.0000000000002931 | DOI Listing |
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