Toward a Cross-Pathway Susceptibility Profile for Urinary Tract Infection After Pelvic Floor Reconstruction

AIM: Urinary tract infection (UTI) is a frequent early complication after pelvic floor reconstruction. This study examined whether perioperative UTI is associated primarily with the surgical approach or with recurring patient-, disease-, and care-related factors.

Methods

Medical records were retrospectively reviewed for 376 women treated with pelvic floor reconstructive surgery from 2020 through 2025. According to the principal reconstructive procedure, the cohort was divided into three surgical strata: mesh-based sacrospinous fixation accompanied by transobturator tape (TOT) or tension-free vaginal tape (TVT) insertion; combined anterior and posterior colporrhaphy with a midurethral sling; and anterior and posterior colporrhaphy performed without an associated sling procedure. The study endpoint was a symptomatic urinary tract infection confirmed by urine culture during the initial hospital admission. Associations between candidate predictors and infection were estimated separately within each surgical stratum. Stratum-level effect estimates were then integrated using a DerSimonian–Laird random-effects model to obtain pooled odds ratios and 95% confidence intervals. Cross-stratum variability was quantified through Cochran’s Q test and the I2 statistic.