Hygiene and urinary tract infections after cystectomy in 452 Swedish survivors of bladder cancer

• Published in: BJU international Vol. 105; no. 8; pp. 1107 - 1117
• Main Authors: Thulin, Helena, Steineck, Gunnar, Kreicbergs, Ulrika, Onelöv, Erik, Ahlstrand, Christer, Carringer, Malcolm, Holmäng, Sten, Ljungberg, Börje, Malmström, Per‐Uno, Robinsson, David, Wijkström, Hans, Wiklund, N. Peter, Henningsohn, Lars
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.04.2010; Wiley-Blackwell
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Cystectomy; Epidemiology. Vaccinations; Female; Follow-Up Studies; General aspects; Humans; Hygiene; Infectious diseases; Male; Medical sciences; MEDICIN; Medicin och hälsovetenskap; MEDICINE; Middle Aged; Nephrology. Urinary tract diseases; Postoperative Complications - etiology; Postoperative Complications - prevention & control; Quality of Life; Survivors - statistics & numerical data; Tumors of the urinary system; Urinary Bladder Neoplasms - surgery; Urinary Diversion; Urinary Reservoirs, Continent; Urinary tract infections; Urinary Tract Infections - etiology; Urinary Tract Infections - prevention & control; Urinary tract. Prostate gland; Urologi och njurmedicin; Urology and Nephrology; Sweden; Europe; Nephrology; Urinary system disease; Urinary diversion; Survivor; Urinary tract disease; Malignant tumor; Bladder cancer; Urology; Swedish; Cystectomy; Urinary tract infection; Treatment; Surgery; urinary tract infections; Bladder disease; Hygiene; Cancer
• ISSN: 1464-4096; 1464-410X; 1464-410X
• DOI: 10.1111/j.1464-410X.2009.08909.x

Study Type – Symptom prevalence (retrospective cohort)
Level of Evidence 2b OBJECTIVES To determine whether or not an improved hygiene can lessen the incidence of symptomatic urinary tract infections (UTIs) in patients treated by cystectomy for urinary bladder cancer. PATIENTS AND METHODS We attempted to contact during their follow‐up all men and women aged 30–80 years who had undergone cystectomy and urinary diversion at seven Swedish hospitals. During a qualitative phase we identified hygienic measures and included them in a study‐specific questionnaire. The patients completed the questionnaire at home. Outcome variables were dichotomized and the results presented as relative risks (RR) with 95% confidence interval. RESULTS We received the questionnaire from 452 (92%) of 491 identified patients. The proportion of patients who had a symptomatic UTI in the previous year was 22% for orthotopic neobladder and cutaneous continent reservoir, and 23% for non‐continent urostomy diversion. The RR for a UTI was 1.1 (0.5–2.5) for ‘never washing hands’ before handling with catheters or ostomy material. Patients with diabetes mellitus had a RR of 2.1 (1.4–3.2) for having a symptomatic UTI. CONCLUSIONS We could not confirm lack of hygiene measures as a cause of UTI for men and women who had a cystectomy with urinary diversion. Patients with diabetes mellitus have a greater risk of contracting a UTI.