Incidence of Post-Up Urinary Tract Infections After Routine Cystoscopy in Minimally Invasive Robotic Gynecologic Surgery

Abstract

Study Objective The aim of this study is to investigate the incidence of post-op urinary tract infections (UTIs) after routine cystoscopy in robotic-assisted gynecologic surgery and to compare the rate to reported incidence of similar gynecologic surgeries without the use of routine cystoscopy. Design Retrospective study utilizing a single gynecologic oncologist database (July 1, 2017 to March 30, 2019) in which routine cystoscopy was performed to detect urinary tract injury following robotic total hysterectomies (RTH) for surgical treatment of benign and malignant pathologies (N= 151). Data was analyzed using Chi-square test, unpaired t-test, and bivariate correlation. Setting Patients were in low lithotomy, Trendelenburg position for enhanced manipulation of uterus. Patients or Participants 151 patients underwent robotic total hysterectomy with bilateral salpingo-oophorectomy and total pelvic lymphadenectomy, after which a cystoscopy was performed to evaluate integrity of ureteral function and any bladder injury. Interventions Routine cystoscopy after surgery. Measurements and Main Results Routine cystoscopy did not find urinary tract injuries in any of the patients. Out of 151 patients, 21 (13.9%) has post-op UTIs within 30 days of routine cystoscopy. Patients with post-op UTIs had higher median operating room time, younger age, more complex surgeries, and higher estimated blood loss (EBL) (Table 1). Patients with a post-op UTI had a higher incidence of a malignant post-op diagnosis. Increased incidence of post-op UTIs were also statistically significantly associated with longer surgery duration, p Conclusion Younger patients with an increased EBL and longer surgeries were associated with a higher rate of post-op UTI after routine cystoscopy in robotic-assisted gynecologic surgery. UTI's are common in women undergoing gynecologic surgery; however, the rate appears to be higher with routine cystoscopy in this small cohort. Consideration of a larger sample size merits further investigation.