{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T03:04:02Z","timestamp":1781838242721,"version":"3.54.5"},"reference-count":41,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2019,6,20]],"date-time":"2019-06-20T00:00:00Z","timestamp":1560988800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Synthetic midurethral slings are the most common procedures currently performed for stress urinary incontinence in women. Infection is a frequent complication of urogynecologic surgery. We performed a systematic review and meta\u2010analysis to identify interventions that successfully prevent infections, including urinary tract infection (<jats:styled-content style=\"fixed-case\">UTI<\/jats:styled-content>) and\/or bacteriuria, compared with no intervention, in women undergoing midurethral sling surgery with or without concomitant pelvic reconstructive procedures for prolapse.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>The primary outcome was the development of any infection post\u2010midurethral sling placement in women. <jats:styled-content style=\"fixed-case\">MEDLINE<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> Embase<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> CINAHL<\/jats:styled-content> and the Cochrane Library were searched for comparative studies from inception to July 2017, with no language restrictions. We used search terms related to midurethral sling, infections and infection\u2010reduction interventions. Two independent reviewers abstracted data and assessed study quality. Pooled effect size estimates were calculated. We conducted meta\u2010analysis of eligible studies. A protocol for this review has been registered and can be accessed online (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/hdl.handle.net\/2429\/64731\">http:\/\/hdl.handle.net\/2429\/64731<\/jats:ext-link>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified seven eligible studies of infection risk\u2010reducing interventions; all focused on <jats:styled-content style=\"fixed-case\">UTI<\/jats:styled-content>s. Only one study assessed preoperative antibiotics with midurethral sling alone and was halted early because of low <jats:styled-content style=\"fixed-case\">UTI<\/jats:styled-content> rates. All other studies (three randomized control trials and three observational studies) examined whether postoperative antibiotics decrease <jats:styled-content style=\"fixed-case\">UTI<\/jats:styled-content>\/bacteriuria rates after midurethral sling with or without reconstructive procedures for pelvic organ prolapse and using bladder catheterization postoperatively. Due to considerable clinical heterogeneity, we only combined four studies for meta\u2010analysis. Postoperative oral prophylactic nitrofurantoin showed no significant benefit in reducing <jats:styled-content style=\"fixed-case\">UTI<\/jats:styled-content>\/bacteriuria in women post\u2010midurethral sling with or without concomitant reconstructive pelvic surgery and the need for bladder catheterization, when compared with the reference group (pooled relative risk 0.73, 95% <jats:styled-content style=\"fixed-case\">confidence interval [CI]<\/jats:styled-content> 0.42\u20101.25).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Based on the best available evidence, postoperative oral nitrofurantoin is not effective at reducing <jats:styled-content style=\"fixed-case\">UTI<\/jats:styled-content>\/bacteriuria rates in catheterized women after midurethral sling with or without concomitant pelvic reconstructive surgery for prolapse. For midurethral sling alone, preoperative antibiotic prophylaxis may not be needed for <jats:styled-content style=\"fixed-case\">UTI<\/jats:styled-content> prevention.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.13661","type":"journal-article","created":{"date-parts":[[2019,5,21]],"date-time":"2019-05-21T22:59:58Z","timestamp":1558479598000},"page":"1514-1522","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Urinary tract infection prevention after midurethral slings in pelvic floor reconstructive surgery: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4937-1913","authenticated-orcid":false,"given":"May S.","family":"Sanaee","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology University of British Columbia Vancouver BC Canada"},{"name":"Department of Obstetrics and Gynecology University of Alberta Edmonton AB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer A.","family":"Hutcheon","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of British Columbia Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9942-5540","authenticated-orcid":false,"given":"Maryse","family":"Larouche","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology McGill University Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen L.","family":"Brown","sequence":"additional","affiliation":[{"name":"Woodward Library University of British Columbia Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terry","family":"Lee","sequence":"additional","affiliation":[{"name":"Center for Health Evaluation and Outcome Sciences University of British Columbia Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roxana","family":"Geoffrion","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of British Columbia Vancouver BC Canada"},{"name":"Center for Health Evaluation and Outcome Sciences University of British Columbia Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,6,20]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181660c1b"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000286"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181f73729"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/614950"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-015-2861-z"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002931"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2017.07.015"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002670"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(16)35222-7"},{"key":"e_1_2_10_11_1","first-page":"2262","article-title":"Best practice policy statement on urologic surgery antimicrobial prophylaxis","volume":"180","author":"Wolf JS Jr","year":"2014","journal-title":"J Urol"},{"key":"e_1_2_10_12_1","unstructured":"National Institute for Health and Care Excellence.Surgical site infections: prevention and treatment. 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