ABSTRACT
INTRODUCTION AND HYPOTHESIS: Despite the lack of evidence, antibiotic prophylaxis has been recommended for midurethral sling procedures. The goal of this study was to evaluate the rate of infectious complications in women undergoing midurethral sling procedures without antibiotic prophylaxis. METHODS: We reviewed the baseline characteristics and postoperative infectious complications of 174 consecutive women who underwent midurethral sling procedures without prophylactic antibiotics from April 2005 to January 2010. Patients undergoing concomitant vaginal surgery were excluded. RESULTS: The average age, parity, and body mass index of were 51.3 ± 12.6 years, 2.4 ± 1.3, and 30.1 ± 7.4 kg/m(2), respectively. There were no wound infections, 2 (1.4%) vaginal mesh exposures and 12 (8%) cases of bacteriuria. CONCLUSIONS: The risk of infections is low when a midurethral sling is performed without antibiotic prophylaxis. Antibiotic prophylaxis does not appear to offer any benefit in midurethral sling procedures.
Subject(s)
Antibiotic Prophylaxis , Gynecologic Surgical Procedures/methods , Preoperative Care , Suburethral Slings , Urinary Incontinence, Stress/surgery , Urinary Tract Infections/prevention & control , Adult , Anti-Bacterial Agents/therapeutic use , Cefazolin/therapeutic use , Female , Follow-Up Studies , Humans , Middle Aged , Prevalence , Retrospective Studies , Risk Factors , Treatment OutcomeABSTRACT
INTRODUCTION AND HYPOTHESIS: The objective of this study was to determine if prophylactic antibiotic use before midurethral sling procedures reduces infectious complications. METHODS: In this double-blinded randomized trial, we compared infectious complications between women who received cefazolin and placebo before midurethral sling procedures. RESULTS: The study was halted due to low rate of infectious outcomes seen at the first scheduled interim analysis. We enrolled 29 women in the cefazolin group and 30 in the placebo group. Total follow-up was 6 months (3-24 months). The groups were similar at the baseline. There was no statistically significant difference between the cefazolin and placebo groups, respectively, with respect to wound infections [1 (3.3%) and 0 (0%)], mesh exposure [0 (0%) and 1 (3.5%)], and bacteriuria [3 (10%) and 1 (3.5%)]. CONCLUSION: Because infection rates are low in both cefazolin and placebo groups, omitting preoperative antibiotics for midurethral slings may be justified.
