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Randomized controlled trial of silver-alloy-impregnated suprapubic catheters versus standard suprapubic catheters in assessing urinary tract infection rates in urogynecology patients

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Abstract

Introduction and hypothesis

Catheter-associated urinary tract infections (UTI) are the most common health-care-related infections. We aimed to compare the UTI rate among women undergoing urogynecological procedures with a silver-alloy suprapubic catheter (SPC) and a standard SPC, and identify the risk factors predisposing patients to UTI.

Methods

Patients who were to undergo placement of an SPC as part of pelvic organ prolapse surgery were enrolled between 1 August 2011 and 30 August 2017, and randomized to either standard SPC or silver-alloy SPC. Follow-up was performed at a postoperative visit or via a phone call at 6 weeks. The primary outcome was UTI.

Results

Of the 288 patients who were randomized, 127 with standard SPC and 137 with silver-alloy SPC were included in the analysis. Twenty-nine out of 123 women with standard SPC (23.6%) and 24 out of 131 (18.3%) with silver-alloy SPC were diagnosed with UTI within 6 weeks postoperatively (p = 0.30). In univariate analysis, non-white race (odds ratio [OR] 5.36, 95% CI 1.16–24.73) and diabetes (OR 2.80, 95% CI 1.26–6.23) were associated with increased risk of UTI. On multivariate analysis, only diabetes remained an independent risk factor. Comparisons between groups were evaluated using two-sample t test for age, Chi-squared tests for diabetes, and Wilcoxon rank sum test for all other variables.

Conclusion

There was only a 5% difference in 6-week UTI rates between those who received standard vs silver-alloy SPC; the study was not powered to detect such a small difference. Diabetes was identified as a risk factor for SPC-associated UTI in women undergoing pelvic reconstructive surgeries.

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Acknowledgements

We would like to thank Maureen Lemens for assistance with data collection.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Florida, 653-1 W. 8th Street, Jacksonville, FL, 32209, USA

    Ruchira Singh

  2. Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN, USA

    Erik D. Hokenstad, Sheila R. Wiest, Christopher J. Klingele, Emanuel C. Trabuco & John B. Gebhart

  3. Department of Obstetrics and Gynecology, University of Calgary, Calgary, AB, Canada

    Shunaha Kim-Fine

  4. Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA

    Amy L. Weaver & Michaela E. McGree

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  1. Ruchira Singh
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Correspondence to Ruchira Singh.

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Conflicts of interest

John B. Gebhart: royalties from UpToDate and Elsevier. All the other authors declare that they have no conflicts of interest.

Additional information

Clinical trial identification no: NCT01359046. Available at: https://clinicaltrials.gov/ct2/show/NCT01359046

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Singh, R., Hokenstad, E.D., Wiest, S.R. et al. 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 (2019). https://doi.org/10.1007/s00192-018-3726-z

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  • DOI: https://doi.org/10.1007/s00192-018-3726-z

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