Abstract
INTRODUCTION AND OBJECTIVE: To describe urinary tract infections (UTIs) after robot-assisted radical cystectomy (RARC) and investigate the variables associated with it. METHODS: A retrospective review of 616 patients who underwent RARC from 2005 to 2019 was performed. Patients were divided into those who developed UTI and those who did not. Patients who developed UTI were further subdivided into three subgroups according to the onset of first UTI (within 30 days, 30-90 days and >90-day after RARC). Kaplan-Meier method was used to depict time to UTI. Multivariate analysis was used to investigate variables associated with UTI and recurrent UTIs. RESULTS: 240 (39%) patients were diagnosed with UTI after RARC. Of these, 48% occurred within 30-days, 17% within 30-90 days, and 35% after 90 days after RARC. The median (IQR) time to develop UTI was 1 (0.3- 7) month. UTI-free probability was 74%, 71%, 67% and 61% at 3, 6, 12 and 24 months, respectively (Figure 1a). Enterococcus Faecalis was the most common causative organism, followed by Escherichia Coli, then Klebsiella Pneumoniae. Highest antibiotic resistance was observed for penicillin and fluoroquinolones, while highest sensitivity was observed for aminoglycosides, trimethoprim-sulfamethoxazole, and cefepime (Figure 1b). On multivariate analysis, patients who received prolonged hospital stay (p < 0.01), received adjuvant chemotherapy (p < 0.01), renal failure postoperatively (p<0.01), postoperative hydronephrosis (p < 0.01) and ureteroileal anastomotic stricture (p < 0.01) were associated with developing UTI and multiple UTIs after RARC (Table 1b). CONCLUSIONS: UTI is common after RARC mainly within 1st month. Multiple risk factors were associated with UTIs following RARC, including continent urinary diversion, prolonged hospital stay, receiving adjuvant chemotherapy, renal failure, postoperative hydronephrosis and ureteroileal anastomotic strictures.Source of Funding: Roswell Park Alliance Foundation
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