Smoking, prolonged catheterization a major risk factor for UTI after radical hysterectomy

For women with cervical cancer who are undergoing radical hysterectomy, preoperative tobacco use and prolonged catheterization appear to contribute to an increased risk of developing postoperative catheter-associated urinary tract infections (UTIs), as reported in a study.

Researchers searched the institutional Gynecologic Oncology surgical and tumour databases and identified women who underwent radical hysterectomy for cervical cancer for study inclusion. They reviewed the women’s medical records to estimate the rate of catheter-associated UTIs after the surgical procedure and identify additional risk factors for developing catheter-associated UTIs.

A total of 160 women were included in the analysis. None of these women had prior urinary tract injury and preoperative chemoradiation. Catheter-associated UTI was defined as an infection diagnosed in a catheterized individual or within 48 hours of catheter removal, with significant bacterial load in urine (>103 cfu/mL) and symptoms or signs attributable to the urinary tract.

Catheter-associated UTIs occurred in 12.5 percent of the population. In univariate analysis, this postoperative complication was strongly associated with current smoking history (odds ratio [OR], 3.76, 95 percent confidence interval [CI], 1.39–10.08), minimally invasive surgical approach (OR, 5.24, 95 percent CI, 1.91–16.87), estimated surgical blood loss >500 mL (OR, 0.18, 95 percent CI, 0.04–0.57), operative time >300 minutes (OR, 2.92, 95 percent CI, 1.07–9.36), and increased duration of catheterization (OR, 18.46, 95 percent CI, 3.67–336).

Following adjustments for potential confounders, the associations persisted for current smoking history (adjusted OR [aOR], 3.94, 95 percent CI, 1.28–12.37) and catheterization for >7 days (aOR, 19.49, 95 percent CI, 2.78–4.27).

The findings highlight the importance of preoperative smoking cessation interventions for current smokers and catheter removal within 7 postoperative days to decrease the risk of postoperative complications, including catheter-associated UTIs.