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Is antibiotic prophylaxis necessary in mid-urethral sling surgery?
Int Urogynecol J. 2020 Jul 02 [Online ahead of print]IU

Abstract

INTRODUCTION AND HYPOTHESIS

Antibiotic prophylaxis is commonly used when implanting a mid-urethral sling (MUS) for female stress urinary incontinence. Use of antibiotics may lead to adverse events and the development of antibiotic resistance. This study compared a variety of outcomes after MUS surgery with and without antibiotic prophylaxis using data from the national Norwegian Female Incontinence Registry.

METHODS

Preoperative and 6-12 months postoperative subjective and objective data from 28,687 patients who received MUS surgery from 1998 through 2017 were extracted from the registry. Categorical outcomes were compared between women with or without antibiotic prophylaxis using chi-square test for independence. Primary outcome was incidence of postoperative surgical site infection (SSI). Secondary outcomes were incidence of tape exposure, de novo or persistent urgency urinary incontinence, postoperative pain > 3 months, subjective and objective cure rates, and patient satisfaction.

RESULTS

Antibiotic prophylaxis was used in 9131 and not used in 19,556 patients. SSIs and prolonged postoperative pain occurred significantly more often without antibiotic prophylaxis. Subjective and objective cure rates were significantly higher and tape exposures significantly lower in women not receiving prophylactic antibiotics. There were no significant differences in other outcomes.

CONCLUSIONS

Antibiotic prophylaxis resulted in fewer women developing postoperative infections or prolonged postoperative pain after MUS surgery, but did not offer protection against tape exposure. The differences in cure rates were small and probably without clinical relevance. If a small increase in surgical site infections is accepted, the routine use of antibiotic prophylaxis can probably be omitted.

Authors+Show Affiliations

Department of Gynecology, Oslo University Hospital, Ullevål, PO Box 4956 Nydalen, 0424, Oslo, Norway. RUNSVE@ous-hf.no. Faculty of Medicine, University of Oslo, Oslo, Norway. RUNSVE@ous-hf.no. The Norwegian Female Incontinence Registry, Oslo University Hospital, Ullevål, Oslo, Norway. RUNSVE@ous-hf.no.The Norwegian Female Incontinence Registry, Oslo University Hospital, Ullevål, Oslo, Norway.Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway.Department of Obstetrics and Gynecology, Vestfold Hospital Trust, Tønsberg, Norway.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32617638

Citation

Svenningsen, Rune, et al. "Is Antibiotic Prophylaxis Necessary in Mid-urethral Sling Surgery?" International Urogynecology Journal, 2020.
Svenningsen R, Kulseng-Hanssen S, Kråkenes EBC, et al. Is antibiotic prophylaxis necessary in mid-urethral sling surgery? Int Urogynecol J. 2020.
Svenningsen, R., Kulseng-Hanssen, S., Kråkenes, E. B. C., & Schiøtz, H. A. (2020). Is antibiotic prophylaxis necessary in mid-urethral sling surgery? International Urogynecology Journal. https://doi.org/10.1007/s00192-020-04408-z
Svenningsen R, et al. Is Antibiotic Prophylaxis Necessary in Mid-urethral Sling Surgery. Int Urogynecol J. 2020 Jul 2; PubMed PMID: 32617638.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Is antibiotic prophylaxis necessary in mid-urethral sling surgery? AU - Svenningsen,Rune, AU - Kulseng-Hanssen,Sigurd, AU - Kråkenes,Ellen Bettina Casanova, AU - Schiøtz,Hjalmar August, Y1 - 2020/07/02/ PY - 2020/04/16/received PY - 2020/06/22/accepted PY - 2020/7/4/entrez KW - Antibiotic prophylaxis KW - Mid-urethral slings JF - International urogynecology journal JO - Int Urogynecol J N2 - INTRODUCTION AND HYPOTHESIS: Antibiotic prophylaxis is commonly used when implanting a mid-urethral sling (MUS) for female stress urinary incontinence. Use of antibiotics may lead to adverse events and the development of antibiotic resistance. This study compared a variety of outcomes after MUS surgery with and without antibiotic prophylaxis using data from the national Norwegian Female Incontinence Registry. METHODS: Preoperative and 6-12 months postoperative subjective and objective data from 28,687 patients who received MUS surgery from 1998 through 2017 were extracted from the registry. Categorical outcomes were compared between women with or without antibiotic prophylaxis using chi-square test for independence. Primary outcome was incidence of postoperative surgical site infection (SSI). Secondary outcomes were incidence of tape exposure, de novo or persistent urgency urinary incontinence, postoperative pain > 3 months, subjective and objective cure rates, and patient satisfaction. RESULTS: Antibiotic prophylaxis was used in 9131 and not used in 19,556 patients. SSIs and prolonged postoperative pain occurred significantly more often without antibiotic prophylaxis. Subjective and objective cure rates were significantly higher and tape exposures significantly lower in women not receiving prophylactic antibiotics. There were no significant differences in other outcomes. CONCLUSIONS: Antibiotic prophylaxis resulted in fewer women developing postoperative infections or prolonged postoperative pain after MUS surgery, but did not offer protection against tape exposure. The differences in cure rates were small and probably without clinical relevance. If a small increase in surgical site infections is accepted, the routine use of antibiotic prophylaxis can probably be omitted. SN - 1433-3023 UR - https://www.unboundmedicine.com/medline/citation/32617638/Is_antibiotic_prophylaxis_necessary_in_mid-urethral_sling_surgery L2 - https://dx.doi.org/10.1007/s00192-020-04408-z DB - PRIME DP - Unbound Medicine ER -
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