Are Pelvic Floor Ultrasound Findings Associated With Recurrent Urinary Tract Infections in Women With Suburethral Slings?

Abstract

<h4>Introduction</h4>Recurrent urinary tract infections (rUTI) are a known complication following urogynaecology surgery, including anti-incontinence suburethral sling (SUS) insertion. Pelvic Floor Ultrasound (PFUS) can be used to accurately assess SUS characteristics, including position, configuration and tension. The purpose of this study is to investigate potential associations of these parameters with the occurrence of rUTI, as this knowledge could help guide clinical management.<h4>Methods</h4>A retrospective observational study of 283 consecutive pelvic floor ultrasounds was completed at a single large tertiary centre in Auckland, New Zealand. Following exclusions, a total of 204 women were included. Comparisons were performed using statistical analysis as appropriate.<h4>Results</h4>125 women had a single intact SUS, and 79 women had no pelvic mesh or sling. rUTI was more common in patients with a SUS (21.6%) than those without SUS or other pelvic mesh (5.1%) (p = 0.001). Almost a quarter of patients (22.4%) had a SUS with an SPG < 8 mm, a marker of increased tension, and this was associated with a significantly higher frequency of rUTI (39.3% compared to 16.5% with SPG ≥ 8 mm) (p = 0.017). Women with SUS and PVR > 100 mL were more likely to have rUTI than those with a SUS and PVR < 100 mL (p = 0.007). No significant association was found between an abnormal SUS configuration and rUTI, or between the type of SUS and rUTI.<h4>Conclusion</h4>Recurrent UTI is more common in women with a SUS, even in this symptomatic cohort. More frequent rUTIs occur when SPG is < 8 mm and/or a PVR > 100 mL. Women with rUTI in the context of SUS may benefit from PFUS assessment to guide management. Further studies to clarify the significance of PFUS findings are needed.