Catheterization Increases UTI Risk in Gynecologic Surgery

TOPLINE:

Routine catheterization during minor gynecologic surgeries is associated with more than double the rate of UTIs compared with procedures without catheterization. Among 762 patients undergoing minor gynecologic procedures, 42.4% received catheterization despite no clear medical indication.

METHODOLOGY:

• Researchers conducted a retrospective cohort study at a tertiary care community hospital, analyzing data from 762 patients who underwent minor gynecologic surgeries from January 1 to December 31, 2021.
• Participants ranged in age from 19 to 89 years (mean, 45.9 years; SD, 13.8) with body mass index ranging from 16.8 to 69.2 (mean, 32.8; SD, 9.2).
• Analysis included procedures taking ≤ 45 minutes, such as hysteroscopy, loop electrosurgical excision procedure, cold knife conization procedures, and suction dilation and curettage.
• Investigators defined UTI as symptomatic dysuria or hematuria, with or without urinary frequency or urgency, accompanied by pyuria on urinalysis.

TAKEAWAY:

• The overall catheterization rate for minor gynecologic procedures was 42.4% (n = 323), with medical comorbidities significantly higher in the catheterization group (49.5% vs 25.7%; P
• Patients who received catheterization showed a significantly higher UTI rate (5.6%; n = 18/323) than those who didn’t receive catheterization (2.5%; n = 11/439) (P = .03).
• According to the authors, patients typically receive approximately 1000 mL of fluid during a 45-minute gynecologic surgery and can void without difficulty, with minimal risk for postoperative catheterization.

IN PRACTICE:

“There is no consensus on the use of routine catheterization at the time of minor gynecologic surgeries such as hysteroscopy or loop electrosurgical excision procedure. Currently, placement of a catheter is guided by individual physician discretion,” wrote the authors of the study.

SOURCE:

The study was led by Salina Zhang, MD, Department of OB/GYN, Summa Health, Akron, Ohio. It was published online in Obstetrics & Gynecology.

LIMITATIONS:

The researchers acknowledge that postoperative follow-up data were not collected, potentially missing some UTI cases. Additionally, regression analyses could not be conducted due to the small number of UTI events, limiting the ability to control for confounding factors.

DISCLOSURES:

The authors reported no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.