A nationwide surveillance of surgical site infection after mid-urethral slings in Japan |
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| Institution: | 1. Department of Urology, Jichi Medical University, Tochigi, Japan;2. Yazawa Clinic, Tokyo, Japan;3. Department of Urology, Keio University, School of Medicine, Tokyo, Japan;4. Department of Urology, Hyogo College of Medicine, Hyogo, Japan;5. Department of Urology, Tokyo Medical University, Tokyo, Japan;6. Department of Urology, Nihon University School of Medicine, Tokyo, Japan;7. Urogynecology Center, First Towakai Hospital, Osaka, Japan;8. Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan;9. Department of Urology, Sanda City Hospital, Hyogo, Japan;10. Department of Urology, Jikei University School of Medicine, Katsushika Medical Center, Tokyo, Japan;11. The Japanese Research Group for Urinary Tract Infection (JRGU), Japan;12. The Japanese Society of Pelvic Organ Prolapse Surgery (JPOPS), Japan;1. Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku, Tokyo, 162-8655, Japan;2. Department of Diagnostic Radiology, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku, Tokyo, 162-8655, Japan;1. Department of Infectious Diseases, Tokyo Metropolitan Bokutoh General Hospital, Tokyo, Japan;2. Department of Infectious Diseases, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan;3. Department of Infectious Diseases, Tokyo Metropolitan Health and Medical Corporation Ebara Hospital, Tokyo, Japan;4. Department of Transfusion Medicine, Tokyo Metropolitan Bokutoh General Hospital, Tokyo, Japan;1. Department of Urology, Toho University Medical Center Ohashi Hospital, Meguro-ku, Tokyo, Japan;2. Group2 Discovery Research Laboratories, Ono Pharmaceutical Co, Ltd, Mishima-gun, Osaka, Japan;1. Department of General Internal Medicine, Osaka University Hospital, Osaka, Japan;2. Division of Infection Control and Prevention, Osaka University Hospital, Osaka, Japan;3. Laboratory for Clinical Investigation, Osaka University Hospital, Osaka, Japan;1. Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, Japan;2. Department of Hematology, Fukui Red Cross Hospital, 2-4-1 Tsukimi, Fukui City, Fukui, 918-8501, Japan |
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| Abstract: | We performed a questionnaire-based, retrospective, nationwide survey on perioperative management and antimicrobial prophylaxis for mid-urethral sling surgery for stress urinary incontinence in Japan to realize the clinical practice and risk factors for SSI.Records of women receiving transobturator tape (TOT) and tension-free vaginal tape (TVT) surgeries from 2010 to 2012 were obtained from hospitals belonging to the Japanese Society of Pelvic Organ Prolapse Surgery. The questionnaire addressed hospital volume, perioperative management, and SSI. Risk factors for SSI were investigated by comparing cases with and without SSI.The data from 97 hospitals and a total 1627 TOT and 1045 TVT surgeries were analyzed. Mean case volumes of TOT and TVT surgeries were 7.3 ± 14.9 and 7.1 ± 17.8 cases per year, respectively. Preoperative hair removal, bowel preparation, and urine culture were routinely performed at 44 (45.3%), 31 (32.0%), and 22 (22.7%) hospitals, respectively. First-generation (51.5%) or second-generation (34.0%) cephalosporin was mostly used for antimicrobial prophylaxis. SSI was reported only in 6 patients (0.22%) and none of them developed abscesses. None of the factors we could evaluate from the questionnaire were found to be significantly associated with SSI.SSI after mid-urethral slings rarely occurred in Japan (0.22%) and no parameters about perioperative managements significantly increased SSI. However, further studies with more detail information of each patient and operation are required to confirm their appropriate perioperative managements for mid-urethral slings. |
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| Keywords: | Surgical site infection Stress urinary incontinence Mid-urethral slings Questionnaire survey Perioperative management |
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