Prolonged Indwelling Foley Catheter Use in Post-operative Gynecology Patient Associated with an Increased Incidence of Urinary Tract Infections

Edy Ardiansyah; Arvitamuriany Triyanthi Lubis; Mohammad Iman Syahputra

doi:10.3889/oamjms.2021.6288

Authors

Edy Ardiansyah Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
Arvitamuriany Triyanthi Lubis Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
Mohammad Iman Syahputra Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2021.6288

Keywords:

Urinary tract infection, Gynecology surgery, Catheter

Abstract

BACKGROUND: Urinary tract infection (UTI) is one of the common conditions and significantly contributes to expensive health treatment and associated with gynecological surgery which increases the cases up to 50% in women undergoing specific reconstructive procedures. Besides that, one indicator of surgical quality was post-operative UTI occurrence.

AIM: This study aims to assess the relationship between Foley catheter usage and UTIs after gynecological surgery with a urinary catheter.

METHODS: A total of 48 subjects examined at the Department of Obstetrics and Gynecology, Universitas Sumatera Utara Hospital, and Haji Adam Malik General Hospital, Medan, from June to September 2020. Subjects were performed urinalysis 8 days after surgery, or earlier if UTI symptoms occur. Personal data and illness data were taken from medical records. Statistical analysis was done using the Chi-square-based test.

RESULTS: There was a significant difference of urine leukocytes in subjects with indwelled catheter for 24–36 h compared to subjects with 36–48 h of catheterization (p = 0.01). The 36–48 h group has a 2.15 odds of developing UTI compared to 24–36 h group (p = 0.01).

CONCLUSION: This study found that prolonged indwelling Foley catheter usage may increase the risk of UTI after gynecology surgery.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Dieter AA, Amundsen CL, Edenfield AL, Kawasaki A, Levin PJ, Visco AG, et al. Oral antibiotics to prevent postoperative urinary tract infection: A randomized controlled trial Obstet Gynecol. 2014;123(1):96-103. https://doi.org/10.1097/aog.0000000000000024 PMid:24463669 DOI: https://doi.org/10.1097/AOG.0000000000000024

Chai J, Pun TC. A prospective randomized trial to compare immediate and 24-hour delayed catheter removal following total abdominal hysterectomy. Acta Obstet Gynecol Scand. 2011;90(5):478-82. https://doi.org/10.1111/j.1600-0412.2011.01104.x PMid:21332450 DOI: https://doi.org/10.1111/j.1600-0412.2011.01104.x

Chang R, Greene MT, Chenoweth CE, Kuhn L, Shuman E, Rogers MA, et al. Epidemiology of hospital-acquired urinary tract-related bloodstream infection at a university hospital. Infect Control Hosp Epidemiol. 2011;32(11):1127-9. https://doi.org/10.1086/522266 PMid:22011543 DOI: https://doi.org/10.1086/522266

Eduardo JC, Alves DS, Hinden IE, Toledano IP, Freitas SG, Mondino PJ, et al. Urinary tract infection and indwelling urinary catheters: Prospective study in gynecological surgery with antibiotic prophylaxis. Sao Paulo Med J. 2015;133(6):517-20. https://doi.org/10.1590/1516-3180.2014.9071412 PMid:26465812 DOI: https://doi.org/10.1590/1516-3180.2014.9071412

El-Nashar SA, Singh R, Schmitt JJ, Leon DC, Arora C, Gebhart JB, Occhino JA. Urinary Tract infection after hysterectomy for benign gynecologic conditions or pelvic reconstructive surgery. Obstet Gynecol. 2018;132(6):1347-57. https://doi.org/10.1097/aog.0000000000002931 PMid:30334857 DOI: https://doi.org/10.1097/AOG.0000000000002931

Enomoto LM, Hollenbeak CS, Bhayani NH, Dillon PW, Gusani NJ. Measuring surgical quality: A national clinical registry versus administrative claims data. J Gastrointest Surg. 2014;18(8):1416-22. https://doi.org/10.1016/j.jss.2013.11.574 PMid:24928187 DOI: https://doi.org/10.1007/s11605-014-2569-2

Fattah AN, Santoso BI. Urinary catheterization in gynecological surgery: When Should it be Removed? Med J Indones. 2013;22(3):183-8. https://doi.org/10.13181/mji.v22i3.589

Ghafourian S, Sekawi Z, Neela V, Khosravi A, Rahbar M, Sadeghifard N. Incidence of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in patients with urinary tract infection. Sao Paulo Med J. 2012;130(1):37-43. https://doi.org/10.1590/s1516-31802012000100007 PMid:22344358 DOI: https://doi.org/10.1590/S1516-31802012000100007

Lake AG, McPencow AM, Dick-Biascoechea MA, Martin DK, Erekson EA. Surgical site infection after hysterectomy. Am J Obstet Gynecol. 2013;209(5):490.e1-9. https://doi.org/10.1097/ogx.0b013e3182a8507f PMid:23770467 DOI: https://doi.org/10.1016/j.ajog.2013.06.018

Lusardi G, Lipp A, Shaw C. Antibiotic prophylaxis for short-term catheter bladder drainage in adults. Cochrane Database Syst Rev. 2013;2013(7):CD005428. https://doi.org/10.1002/14651858.cd005428.pub2 PMid:23824735 DOI: https://doi.org/10.1002/14651858.CD005428.pub2

Weemhoff M, Wassen M, Korsten L, Serroyen J, Kampschöer P, Roumen F. Postoperative catheterization after anterior colporrhaphy: 2 versus 5 days. A multicentre randomized controlled trial. Int Urogynecol J. 2011;22(4):477-83. https://doi.org/10.1007/s00192-010-1304-0 PMid:20960149 DOI: https://doi.org/10.1007/s00192-010-1304-0

Zielinski MD, Thomsen KM, Polites SF, Khasawneh MA, Jenkins DH, Habermann EB. Is the centers for Medicare and Medicaid service’s lack of reimbursement for postoperative urinary tract infections in elderly emergency surgery patients justified? Surgery. 2014;156(4):1009-15. https://doi.org/10.1016/j.surg.2014.06.073 PMid:25239361 DOI: https://doi.org/10.1016/j.surg.2014.06.073

Flores-Mireles AL, Walker JN, Caparon M, Hultgren SJ. Urinary tract infections: Epidemiology, mechanisms of infection and treatment options. Nat Rev Microbiol. 2015;13(5):269-84. https://doi.org/10.1038/nrmicro3432 PMid:25853778 DOI: https://doi.org/10.1038/nrmicro3432

Qin C, Oliveira GD, Hackett NL, Kim JY. Surgical duration and risk of Urinary Tract Infection: An analysis of 1, 452, 369 patients using the national surgical quality improvement program (NSQIP). Int J Surg. 2015;20:107-12. https://doi.org/10.1016/j.ijsu.2015.05.051 PMid:26054658 DOI: https://doi.org/10.1016/j.ijsu.2015.05.051

Choudhury FR, Rashid M, Rumana R, Uddin AB, Ava NN. Short term versus long term catheterization after urogenital prolapse surgery. J Shaheed Suhrawardy Med Coll. 2011;3(2):41-3. https://doi.org/10.3329/jssmc.v3i2.12077 DOI: https://doi.org/10.3329/jssmc.v3i2.12077

Fattah AN, Santoso BI. Urinary catheterization in gynecological surgery: When should it be removed? Med J Indones. 2013;22:183-8. https://doi.org/10.13181/mji.v22i3.589 DOI: https://doi.org/10.13181/mji.v22i3.589

Huang H, Dong L, Gu L. The timing of urinary catheter removal after gynecologic surgery: A meta-analysis of randomized controlled trials. Medicine (Baltimore). 2020;99(2):e18710. https://doi.org/10.1097/md.0000000000018710 PMid:31914080 DOI: https://doi.org/10.1097/MD.0000000000018710

Kranz J, Schmidt S, Wagenlehner F, Schneidewind L. Catheter-associated urinary tract infections in adult patients. Dtsch Arztebl Int. 2020;117(6):83-8. https://doi.org/10.3238/arztebl.2020.0083 PMid:32102727 DOI: https://doi.org/10.3238/arztebl.2020.0083