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Impact of per-operative antibiotics on the urinary tract infection rate following mid-urethral sling surgery for urinary incontinence : a randomized controlled trial

Rudnicki, Martin ; Jakobsson, Ulf LU orcid and Teleman, Pia LU (2019) In International Urogynecology Journal
Abstract

Introduction and hypothesis: The objective was to compare the effect of antibiotics versus no antibiotics prophylaxis per-operatively on the frequency of urinary tract infection (UTI) following mid-urethral sling application to treat stress or mixed urinary incontinence. 

Methods: This study was designed as a multicenter prospective randomized trial. Women were included from eight centers in three countries. Women were aged under 60 years and had objectively verified stress urinary incontinence. Women with mixed urinary incontinence were also included. Randomization was held in blocks for operation with either antibiotics or no antibiotics. UTI was defined in accordance with the Centers for Disease Control (CDC) criteria for... (More)

Introduction and hypothesis: The objective was to compare the effect of antibiotics versus no antibiotics prophylaxis per-operatively on the frequency of urinary tract infection (UTI) following mid-urethral sling application to treat stress or mixed urinary incontinence. 

Methods: This study was designed as a multicenter prospective randomized trial. Women were included from eight centers in three countries. Women were aged under 60 years and had objectively verified stress urinary incontinence. Women with mixed urinary incontinence were also included. Randomization was held in blocks for operation with either antibiotics or no antibiotics. UTI was defined in accordance with the Centers for Disease Control (CDC) criteria for symptomatic UTI. Women were followed up at 3, 12, and 36 months. This was part of a trial comparing subjective cure rate in relation to application of Ajust® (single-incision mid-urethral slings) versus standard mid-urethral slings. 

Results: The main outcome was to evaluate if per-operative antibiotics had any impact on UTI following sling surgery. In total, 305 women were randomized (158 [52%] to antibiotics and 147 [48%] to no antibiotics). Demographic data disclosed no differences between the two groups. The trial did not show any difference between the two groups regarding the frequency of postoperative UTI. Logistic regression analysis disclosed only residual urine volume at 3 months’ follow-up as a significant risk factor for UTIs. Per-operative antibiotics had no influence on the frequency of mesh erosions or any other complication. 

Conclusions: Our trial does not suggest any beneficial effect of per-operative antibiotics on the risk of post-operative UTIs.

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author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Antibiotics, Mid-urethral sling, Mini-sling, Single-incision sling, Stress urinary incontinence, Urinary tract infection
in
International Urogynecology Journal
publisher
Springer
external identifiers
  • pmid:31776620
  • scopus:85075975164
ISSN
0937-3462
DOI
10.1007/s00192-019-04156-9
language
English
LU publication?
yes
id
f5c1c0f2-47f4-4db9-b9df-45295b2161b3
date added to LUP
2020-01-02 16:34:12
date last changed
2024-05-01 03:09:39
@article{f5c1c0f2-47f4-4db9-b9df-45295b2161b3,
  abstract     = {{<p>Introduction and hypothesis: The objective was to compare the effect of antibiotics versus no antibiotics prophylaxis per-operatively on the frequency of urinary tract infection (UTI) following mid-urethral sling application to treat stress or mixed urinary incontinence. </p><p>Methods: This study was designed as a multicenter prospective randomized trial. Women were included from eight centers in three countries. Women were aged under 60 years and had objectively verified stress urinary incontinence. Women with mixed urinary incontinence were also included. Randomization was held in blocks for operation with either antibiotics or no antibiotics. UTI was defined in accordance with the Centers for Disease Control (CDC) criteria for symptomatic UTI. Women were followed up at 3, 12, and 36 months. This was part of a trial comparing subjective cure rate in relation to application of Ajust® (single-incision mid-urethral slings) versus standard mid-urethral slings. </p><p>Results: The main outcome was to evaluate if per-operative antibiotics had any impact on UTI following sling surgery. In total, 305 women were randomized (158 [52%] to antibiotics and 147 [48%] to no antibiotics). Demographic data disclosed no differences between the two groups. The trial did not show any difference between the two groups regarding the frequency of postoperative UTI. Logistic regression analysis disclosed only residual urine volume at 3 months’ follow-up as a significant risk factor for UTIs. Per-operative antibiotics had no influence on the frequency of mesh erosions or any other complication. </p><p>Conclusions: Our trial does not suggest any beneficial effect of per-operative antibiotics on the risk of post-operative UTIs.</p>}},
  author       = {{Rudnicki, Martin and Jakobsson, Ulf and Teleman, Pia}},
  issn         = {{0937-3462}},
  keywords     = {{Antibiotics; Mid-urethral sling; Mini-sling; Single-incision sling; Stress urinary incontinence; Urinary tract infection}},
  language     = {{eng}},
  month        = {{11}},
  publisher    = {{Springer}},
  series       = {{International Urogynecology Journal}},
  title        = {{Impact of per-operative antibiotics on the urinary tract infection rate following mid-urethral sling surgery for urinary incontinence : a randomized controlled trial}},
  url          = {{http://dx.doi.org/10.1007/s00192-019-04156-9}},
  doi          = {{10.1007/s00192-019-04156-9}},
  year         = {{2019}},
}