Is Methenamine Prophylaxis for Urinary Tract Infection After Midurethral Sling As Effective As Antibiotic Prophylaxis?

Description

Stress urinary incontinence (SUI) affects at least 40% of women in the United States. Synthetic polypropylene mid-urethral slings (MUS) are the gold standard treatment for SUI. Post-operative urinary tract infections (UTI) are one of the most common complications after MUS placement. Some studies have demonstrated that MUS placement can increase the risk of UTI up to 21-34%. Post-operative UTI can lead to significant healthcare and patient burden. This additional burden further contributes to an estimated annual cost of $1.6 billion for UTI management in the United States. With increased antibiotic usage, there is simultaneous increase in bacterial resistance leading to treatment refractory UTI. The investigators prescribe post-operative antibiotics prophylactically for 3 days after MUS placement with or without concurrent pelvic reconstructive surgery based on prior literature recommending post-operative prophylaxis. There is a greater emphasis on limiting antibiotic use given the trend of development of bacterial resistance. There are studies supporting alternatives such as methenamine for recurrent UTI prophylaxis treatment, but there are limited studies evaluating methenamine for UTI prophylaxis after MUS.

Conditions

Urinary Tract Infection (Diagnosis)

Study Overview

Study Details

Study overview

Stress urinary incontinence (SUI) affects at least 40% of women in the United States. Synthetic polypropylene mid-urethral slings (MUS) are the gold standard treatment for SUI. Post-operative urinary tract infections (UTI) are one of the most common complications after MUS placement. Some studies have demonstrated that MUS placement can increase the risk of UTI up to 21-34%. Post-operative UTI can lead to significant healthcare and patient burden. This additional burden further contributes to an estimated annual cost of $1.6 billion for UTI management in the United States. With increased antibiotic usage, there is simultaneous increase in bacterial resistance leading to treatment refractory UTI. The investigators prescribe post-operative antibiotics prophylactically for 3 days after MUS placement with or without concurrent pelvic reconstructive surgery based on prior literature recommending post-operative prophylaxis. There is a greater emphasis on limiting antibiotic use given the trend of development of bacterial resistance. There are studies supporting alternatives such as methenamine for recurrent UTI prophylaxis treatment, but there are limited studies evaluating methenamine for UTI prophylaxis after MUS.

Is Methenamine Prophylaxis for Urinary Tract Infection After Midurethral Sling As Effective As Antibiotic Prophylaxis? a Randomized Controlled Trial

Is Methenamine Prophylaxis for Urinary Tract Infection After Midurethral Sling As Effective As Antibiotic Prophylaxis?

Condition
Urinary Tract Infection (Diagnosis)
Intervention / Treatment

-

Contacts and Locations

Morristown

Atlantic Health, Morristown, New Jersey, United States, 07928

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility Criteria

  • 1. Female
  • 2. Age ≥ 18
  • 3. Patients undergoing mid-urethral sling procedure
  • 1. Medication intolerance or allergy to study medications
  • 2. Renal impairment with GFR \<30
  • 3. Breast feeding
  • 4. Pregnancy
  • 5. Recurrent urinary tract infections
  • 6. Active urinary tract infection
  • 7. Immunosuppressive disease
  • 8. Interstitial cystitis

Ages Eligible for Study

18 Years to 100 Years

Sexes Eligible for Study

FEMALE

Accepts Healthy Volunteers

Yes

Collaborators and Investigators

Atlantic Health System,

Study Record Dates

2028-01-30