The following is a summary of “Risk factors for catheter–associated urinary tract infections following radical hysterectomy for cervical cancer,” published in the JUNE 2023 issue of Obstetrics and Gynecology by Mercadel, et al.

Radical hysterectomy is a common treatment for early-stage cervical cancer, but it can lead to urinary tract dysfunction as a complication. Catheter-associated urinary tract infections (CAUTIs) are a significant risk factor associated with prolonged catheterization after radical hysterectomy. For a study, researchers sought to determine the rate of CAUTIs after radical hysterectomy for cervical cancer and identify additional risk factors for developing CAUTIs in this patient population.

They reviewed patients who underwent radical hysterectomies for cervical cancer between 2004 and 2020 with institutional review board approval. Patients were identified from institutional Gynecologic Oncology surgical and tumor databases. The inclusion criteria were radical hysterectomy for early-stage cervical cancer, while exclusion criteria included inadequate hospital follow-up, insufficient records of catheter use, urinary tract injury, and preoperative chemoradiation. CAUTIs were defined as infections diagnosed in catheterized patients or within 48 hours of catheter removal, with significant bacteriuria (>10 cfu/mL) and symptoms or signs related to the urinary tract. Data analysis involved comparative analysis and univariate and multivariable logistic regression using Excel, GraphPad Prism, and IBM SPSS Statistics.

Among the 160 included patients, 12.5% developed CAUTIs. Univariate analysis revealed that CAUTIs were significantly associated with current smoking history (odds ratio [OR] 3.76; 95% CI 1.39-10.08), minimally invasive surgical approach (OR 5.24; 95% CI 1.91-16.87), estimated surgical blood loss >500 mL (OR 0.18; 95% CI 0.04-0.57), operative time >300 minutes (OR 2.92; 95% CI 1.07-9.36), and increased duration of catheterization (OR 18.46; 95% CI 3.67-336). After adjusting for interactions and controlling for potential confounders with multivariable analysis, current smoking history and catheterization for >7 days were identified as independent risk factors for developing CAUTIs (adjusted OR 3.94; 95% CI 1.28-12.37; adjusted OR 19.49; 95% CI 2.78-427).

Preoperative smoking cessation interventions should be implemented for current smokers to reduce the risk of postoperative complications, including CAUTIs, in patients undergoing radical hysterectomy for early-stage cervical cancer. Additionally, early removal of the catheter within seven days postoperatively should be encouraged in all women to decrease the risk of infection.

Source: ajog.org/article/S0002-9378(23)00135-7/fulltext