Postoperative Bacteriuria
Conditions
Keywords
bacteriuria, straight catheterization, urinary tract infections, iatrogenic
Brief summary
This is a prospective randomized controlled trial to look into the reduction of catheter associated urinary tract infections in the postoperative period. It will specifically look at short gynecologic procedures such as D&C (dilation and curettage), hysteroscopies and LEEP procedures and the need to perform intraoperative catheterization. If a patient urinates immediately before a short operation then there is no need to drain the bladder with a catheter during the procedure. The investigators hypothesize that eliminating catheterization during these short procedures may decrease postoperative urinary tract infections. The hope is that this study would provide evidence to support a change in practice.
Detailed description
The majority of research currently concentrates on indwelling catheters rather than one-time catheterization. Current practice at our institution in the gynecologic operating room is to perform a one time catheterization on patient's undergoing short procedures, yet it is unclear if this is a necessary intervention. If patients are asked to void immediately before their procedure it would eliminate the need for intra-operative catheterization and eliminate a potential source of infection. The study is designed to determine whether routine catheterization prior to a minor OB/GYN procedure causes symptomatic or asymptomatic bacteria in the urine. Current practice is one-time catheterization of patients undergoing minor OB/GYN procedures prior to the beginning of the procedure. The investigators hypothesize that this causes asymptomatic or symptomatic bacteriuria.
Interventions
PROCEDUREStraight catheterization
Patient will receive the current standard practice of straight catheterization intraoperatively.
PROCEDURENo straight catheterization
Patients will not be catheterized which is an experimental change from the current practice at our hospital.
Sponsors
Abington Memorial Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* The patient must be 18 years of age or older. * The patient must be female. * The patient must be undergoing a same-day gynecologic procedure where catheterization is usually performed. * The patient must have general anesthesia or monitored anesthesia care (MAC). This includes IV sedation.
Exclusion criteria
* The patient cannot be undergoing intermittent one-time catheterization. * The patient can not have had an indwelling catheter placed in the past 6 months. * The patients cannot have a concomitant pelvic infection. * The procedure cannot require spinal anesthesia. * The patient cannot be taking immunosuppressive medications. * The patient cannot be taking antibiotics and/or suppressive therapy for chronic urinary tract infections. * The patient cannot receive pre-operative or intra-operative antibiotics.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative Bacteriuria | 2 -4 weeks | Urine cultures are obtained preoperatively (baseline), immediately postoperatively and 2 to 4 weeks postoperatively. |
Secondary
| Measure | Time frame |
|---|---|
| Subjective urinary tract discomfort | 2-4 weeks postoperatively |
Other
| Measure | Time frame |
|---|---|
| Symptomatic urinary tract infection | 2-4 weeks |
Countries
United States
Contacts
Primary ContactEmily G Parent, D.O.
Backup ContactVictoria Myers, M.D.
Outcome results
None listed