Objective: The goal of this research was to evaluate the incidence and risk factors of postoperative symptomatic bladder infection in patients undergoing gynecologic oncology surgery. Symptomatic urinary-tract infections (UTIs) following insertion of indwelling bladder catheters is a common postoperative complication. The reported incidence varies from 1.3% 6.5% and even rises up to 42% when asymptomatic bacteriuria is included. Design: This was a retrospective and prospective cohort study. Materials and Methods: The current authors investigated 152 consecutive patients who underwent major surgery (grade 3 and 4) while under gynecologic oncology care. Demographic and clinical data on patient comorbidities, timing of insertion and removal of bladder catheters, intravenous antibiotic prophylaxis, and urinary symptoms and cultures were collected and evaluated statistically. Results: An incidence of 2% symptomatic UTIs postoperatively was identified. In 66% of cases Escherichia coli was the causative microorganism. Having a bladder catheter in situ for ≥24 hours was significantly related to the occurrence of symptomatic UTI postoperatively (p<0.01). Patients' comorbidities (American Society of Anethesiologists score), reduced mobility (World Health Organization score), abdominal surgery, and admission to intensive care/high dependency care units postoperatively were additional significant risk factors for the development of symptomatic UTIs (p<0.001). Conclusions: Gynecologic oncologists need to be aware that a shorter duration of catheterization reduces the risk of UTI following major surgery. Using a minimal-access surgical approach and fostering early mobilization improve and significantly decreases the risk of postoperative bladder infections. (J GYNECOL SURG 30:204)
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