Objectives The aim of this study is to investigate the incidence of post-op infections after routine cystoscopy in robotic-assisted gynecologic cancer surgery and to compare the rate to reported incidence of similar surgeries without the use of routine cystoscopy.
Methods Retrospective study utilizing a single gynecologic oncologist’s database (July 1, 2017 to January 30, 2019) in which routine cystoscopy was performed to detect urinary tract injury following robotic total hysterectomies (RTH) for surgical treatment of endometrial cancer (N=50). Data was analyzed using Chi-square test, unpaired t-test, and bivariate correlation.
Results None of the patients with a known, treated pre-op UTI presented with a post-op UTI within 30 days of surgery. Additionally, the routine cystoscopy did not find urinary tract injuries in any of the patients. Out of 50 patients, 20 (10%) has post-op UTIs within 30 days of routine cystoscopy. Patients with post-op UTIs had higher median operating room time, more complex surgeries, and higher surgical stage compared to the patients without post-op UTIs (table 1). Increased incidence of UTIs were also statistically significantly associated with younger age, higher estimated blood loss (EBL), and higher surgical stage, p<0.05 (table 2).
Conclusions Younger patients with an increased EBL and higher surgical stage endometrial cancer were associated with a higher rate of post-op UTI occurrence after routine cystoscopy in robotic-assisted gynecologic surgery. UTIs are common in women undergoing gynecologic surgery; however, the rate appears to be higher with routine cystoscopy in this small cohort. Consideration of a larger sample size merits further investigation.
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