Understanding Catheterization: How Gynecologic Surgery Increases UTI Risk – Key Insights & Prevention Tips

TOPLINE:

Routine catheterization during minor gynecologic surgeries increases the risk of urinary tract infections (UTIs). A study found that 42.4% of the 762 patients who underwent these procedures received catheters without clear medical reasons.

METHODOLOGY:

• Researchers studied 762 patients at a community hospital between January 1 and December 31, 2021.
• Participants aged 19 to 89 years (average age 45.9; standard deviation 13.8) and had body mass indexes ranging from 16.8 to 69.2 (average 32.8; standard deviation 9.2).
• This analysis focused on surgeries lasting 45 minutes or less, including hysteroscopy and loop electrosurgical excision.
• The study defined UTI based on symptoms of dysuria or hematuria with or without urinary urgency, confirmed by pyuria on urinalysis.

TAKEAWAY:

• The catheterization rate in these surgeries was 42.4% (n = 323). Patients who received catheters had significantly more medical issues (49.5% vs 25.7%; P < 0.01).
• The UTI rate among catheterized patients was 5.6% (18/323) compared to 2.5% (11/439) for those without catheters (P = 0.03).
• Surgeons typically administer around 1000 mL of fluid during surgeries, allowing patients to urinate without complications. Thus, the need for postoperative catheterization is minimal.

IN PRACTICE:

There is no agreement on routine catheter use during minor gynecologic surgeries like hysteroscopy. Currently, catheterization is based on individual doctor preferences.

SOURCE:

The research, led by Dr. Salina Zhang from Summa Health, Akron, Ohio, was published online in Obstetrics & Gynecology.

LIMITATIONS:

The authors did not report any conflicts of interest.