HEALTH OF WOMAN. 2020.9-10(155-156): 54-59; doi:10.3390/jcm9113391
Rechberger Ewa¹, Rechberger Tomasz ¹, Wawrysiuk Sara ¹, Miotla Pawel¹, Kulik-Rechberger Beata ², Kuszka Andrzej³ and Wróbel Andrzej^1
12nd Department of Gynecology, Faculty of Medicine, Lublin Medical University, Lublin, Poland
²Department of Pediatric Propaedeutics, Faculty of Medicine, Lublin Medical University, Lublin, Poland
³Department of Obstetrics and Gynecology, Faculty of Medicine, Pritz, Germany

Urinary tract infections (UTIs) are one of the most common reasons for antibiotic prescriptions among women worldwide. UTIs are also associated with intra- and postoperative catheterization, which is an essential component of many gynecological surgical procedures, including midurethral sling (MUS) placement.
The aim of this study was to compare the incidence of UTI subsequent to a MUS procedure.
The study involved 562 female patients who underwent MUS procedures due to stress urinary incontinence (SUI). Patients were assigned in a 1:1 ratio to two study groups: patients receiving 500 mg of ciprofloxacin three times a day for 3 consecutive days after surgery or patients receiving 5 mL of Canephron taken orally three times a day for 3 weeks.
After analyzing the collected data, it was found that in the group of patients receiving ciprofloxacin, 29 women (10.98%) had a UTI, whereas in the group of patients receiving Canephron^® N, 36 women (13.64%) had a UTI within 6 months after the patient’s MUS procedure. No statistically significant dierence between the two groups was noted. Postoperative prophylaxis with a phytodrug can be perceived as an attractive option in the reduction of antibiotic consumption among female patients after a MUS procedure.
Keywords: urinary tract infection; prophylaxis; midurethral sling; ciprofloxacin; phytodrug.

REFERENCES

1. Foxman B. 1990. Recurring urinary tract infection: Incidence and risk factors. Am. J. Public Health. 80:331–333. [CrossRef]

2. Available online: https://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance (accessed on 2020, August 28).

3. Stamm WE. 1998. Urinary Tract Infections, 4th ed. Bennett JV, Brachman PS, Eds. Lippincott-Raven, Philadelphia, PA. USA:477–483.

4. Foxman B. 2014. Urinary tract infection syndromes: Occurrence, recurrence, bacteriology, risk factors, and disease burden. Infect. Dis. Clin. N. Am. 28:11–13. [CrossRef]

5. Lo E, Nicolle L, Classen D, Arias KM, Podgorny K, Anderson DJ, Burstin H, Calfee DP, Coffin SE, Dubberke ER et al. 2008. Strategies to prevent catheter associated urinary tract infections in acute care hospitals. Infect. Cont. Hosp. Epid. 29:S41–S50. [CrossRef]

6. Crowe H, Clift R, Duggan G, Bolton D, Costello A. 1994. Randomised study of the effect of midnight removal of urinary catheters. Urol. Nurs. 14:18–20.

7. Kamilya G, Seal SL, Mukherji J, Bhattacharyya SK, Hazra A. 2010. A randomized controlled trial comparing short versus long-term catheterization after uncomplicated vaginal prolapse surgery. J. Obstet. Gynaecol. Res. 36:154–158. [CrossRef]

8. Foxman B, Cronenwett AEW, Spino C, Berger MB, Morgan DM. 2015. Cranberry juice capsules and urinary tract infection after surgery: Results of a randomized trial. Am. J. Obstet. Gynecol. 213:194.e1. [CrossRef]

9. Jonsson Funk M, Levin PJ, Wu JM. 2012. Trends in the surgical management of stress urinary incontinence. Obstet. Gynecol. 119:845–851. [CrossRef]

10. Tew L, Pomfret I, King D. 2005. Infection risks associated with urinary catheters. Nurs. Stand. 20:55–61. [CrossRef]

11. Tambyah PA, Halvorson KT, Maki DG. 1999. A prospective study of pathogenesis of catheter associated urinary tract infections. Mayo Clin. Proc. 74:131–136. [CrossRef]

12. Saint S, Greene MT, Krein SL, Rogers MA, Ratz D, Fowler KE, Edson BS, Watson SR, Meyer-Lucas B, Masuga M et al. 2016. A program to prevent catheter-associated urinary tract infection in acute care. N. Engl. J. Med. 374:2111–2119. [CrossRef]

13. Singh R, Hokenstad ED, Wiest SR, Kim-Fine S, Weaver AL, McGree ME, Klingele CJ, Trabuco EC, Gebhart JB. 2019. Randomized controlled trial of silver-alloy-impregnated suprapubic catheters versus standard suprapubic catheters in assessing urinary tract infection rates in urogynecology patients. Int. Urogynecol. J. 30:779–787. [CrossRef]

14. Milan PB, Ivan IM. 2009. Catheter-associated and nosocomial urinary tract infections: Antibiotic resistance and influence on commonly used antimicrobial therapy. Int. Urol. Nephrol. 41:461–464. [CrossRef]

15. Naber KG. 2013. Efficacy and safety of the phytotherapeutic drug Canephron® N in prevention and treatment of urogenital and gestational disease: Review of clinical experience in Eastern Europe and Central Asia. Res. Rep. Urol. 5:39–46.

16. Künstle G, Brenneis C, Haunschild J. 2013. Efficacy of Canephron® N against bacterial adhesion, inflammation and bladder hyperactivity. Eur. Urol. Suppl. 12:e671. [CrossRef]

17. Künstle G, Brenneis C, Pergola C, Werz O, Haunschild J. 2013. Anti-inflammatory effects of Canephron® N and effectiveness in a model of interstitial cystitis. Urologe 52(Suppl. S1):e97.

18. Marcon J, Schubert S, Stief CG, Magistro G. 2019. In vitro efficacy of phytotherapeutics suggested for prevention and therapy of urinary tract infections. Infection 47:937–944. [CrossRef]

19. Nausch B, Pace S, Pein H, Koeberle A, Rossi A, Künstle G, Werz O. 2019. The standardized herbal combination BNO 2103 contained in Canephron® N alleviates inflammatory pain in experimental cystitis and prostatitis. Phytomedicine 60:152987. [CrossRef]

20. Miotla P, Wawrysiuk S, Naber K, Markut-Miotla E, Skorupski P, Skorupska K, Rechberger T. 2018. Should We Always Use Antibiotics after Urodynamic Studies in High-Risk Patients? Biomed. Res. Int. 2018:1607425. [CrossRef]

21. Wagenlehner FM, Abramov-Sommariva D, Höller M, Steindl H, Naber KG. 2018. Non-Antibiotic Herbal Therapy (BNO 1045) versus Antibiotic Therapy (Fosfomycin Trometamol) for the Treatment of Acute Lower Uncomplicated Urinary Tract Infections inWomen: A Double-Blind, Parallel-Group, Randomized, Multicentre, Non-Inferiority Phase III Trial. Urol. Int. 101:327–336.

22. Rechberger T, Futyma K, Jankiewicz K, Adamiak A, Bogusiewicz M, Bartuzi A, Miotła P, Skorupski P, Tomaszewski J. 2011. Tape fixation: An important surgical step to improve success rate of anti-incontinence surgery. J. Urol. 186:180–184. [CrossRef]

23. Kelleher CJ, Cardozo LD, Khullar V, Salvatore S. 1997. A new questionnaire to assess the quality of life of urinary incontinent women. Br. J. Obstet. Gynaecol. 104:1374–1379. [CrossRef] [PubMed]

24. Shumaker SA, Wyman JF, Uebersax JS, McClish D, Fantl JA. 1994. Health related quality of life measures for women with urinary incontinence: The urogenital distress inventory and the incontinence impact questionnaire. Qual. Life Res. 3:291–306. [CrossRef]

25. Uebersax JS, Wyman JF, Shumaker SA, McClish DK, Fantl JA. 1995. Short forms to assess life quality symptom distress for urinary incontinence in women: The incontinence impact questionnaire and the urogenital distress inventory. Neurourol. Urodyn. 14:131–139. [CrossRef] [PubMed]

26. Faul F, Erdfelder E, Lang AG, Buchner A. 2007. G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav. Res. Methods 39:175–191. [CrossRef]

27. Skorupska K, Rechberger T, Bogusiewicz M, Adamiak-Godlewska A, Kwiatkowska A, Miotla P. 2020. Current trends in urogynecological surgeries in Poland. Int. Urogynecol. J. 31:1627–1632. [CrossRef]

28. Marschall J, Carpenter CR, Fowler S, Trautner BW. 2013. CDC Prevention Epicenters Program. Antibiotic Prophylaxis for Urinary Tract Infections After Removal of Urinary Catheter: Meta-Analysis. BMJ 346:f3147. [CrossRef]

29. Davidov MI, Bunova NE. 2018. Comparative assessment of Canephron N and ciprofloxacin as monotherapy of acute uncomplicated cystitis in women. Urologiia 4:24–32. [CrossRef]

30. Savas L, Guvel S, Onlen Y, Savas N, Duran N. 2006. Nosocomial urinary tract infections: Microorganisms, antibiotic sensitivities and risk factors. West Indian Med. J. 55:188–193. [CrossRef]

31. Dudeck MA, Horan TC, Peterson KD, Allen-Bridson K, Morrell G, Anttila A, Pollock DA, Edwards JR. 2013. National Healthcare Safety Network (NHSN) report, data summary for 2011, device-associated module. Am. J. Infect. Control 41:286–300. [CrossRef] [PubMed]

32. Stewart LE, Hall E, Carberry CL. 2018. Cystoscopy at the time of incontinence and prolapse surgery. Curr. Opin. Obstet. Gynecol. 30:441–445. [CrossRef]

33. Falagas ME, Athanasiou S, Iavazzo C, Tokas T, Antsaklis A. 2008. Urinary tract infections after pelvic floor gynecological surgery: Prevalence and effect of antimicrobial prophylaxis. A systematic review. Int. Urogynecol. J. Pelvic. Floor. Dysfunct. 19:1165–1172. [CrossRef] [PubMed]

34. Glavind K, Morup L, Madsen H, Glavind J. 2007. A prospective, randomised, controlled trial comparing 3 hour and 24 hour postoperative removal of bladder catheter and vaginal pack following vaginal prolapse surgery. Acta Obstet. Gynecol. Scand. 86:1122–1125. [CrossRef] [PubMed]

35. Foon R, Toozs-Hobson P, Latthe P. 2012. Prophylactic antibiotics to reduce the risk of urinary tract infections after urodynamic studies. Cochrane Database Syst. Rev. 10:CD008224. [CrossRef] [PubMed]

36. Naber KG, Bonkat G, Wagenlehner FME. 2020. The EAU and AUA/CUA/SUFU Guidelines on Recurrent Urinary Tract Infections: What is the Difference? Eur. Urol. 29, S0302-2838(20)30461-9.

37. Carapeti EA, Andrews SM, Bentley PG. 1996. Randomised study of sterile versus non sterile urethral catheterisation. Ann. R. Coll. Surg. Engl. 78:59–60.

38. Nickel JC, Feero P, Costerton JW, Wilson E. 1989. Incidence and importance of bacteriuria in postoperative, short-term urinary catheterization. Can. J. Surg. 32:131–132.