A nationwide surveillance of surgical site infection after mid-urethral slings in Japan

J Infect Chemother. 2019 Jul;25(7):567-570. doi: 10.1016/j.jiac.2019.03.024. Epub 2019 Apr 17.


We performed a questionnaire-based, retrospective, nationwide survey on perioperative management and antimicrobial prophylaxis for mid-urethral sling surgery for stress urinary incontinence in Japan to realize the clinical practice and risk factors for SSI. Records of women receiving transobturator tape (TOT) and tension-free vaginal tape (TVT) surgeries from 2010 to 2012 were obtained from hospitals belonging to the Japanese Society of Pelvic Organ Prolapse Surgery. The questionnaire addressed hospital volume, perioperative management, and SSI. Risk factors for SSI were investigated by comparing cases with and without SSI. The data from 97 hospitals and a total 1627 TOT and 1045 TVT surgeries were analyzed. Mean case volumes of TOT and TVT surgeries were 7.3 ± 14.9 and 7.1 ± 17.8 cases per year, respectively. Preoperative hair removal, bowel preparation, and urine culture were routinely performed at 44 (45.3%), 31 (32.0%), and 22 (22.7%) hospitals, respectively. First-generation (51.5%) or second-generation (34.0%) cephalosporin was mostly used for antimicrobial prophylaxis. SSI was reported only in 6 patients (0.22%) and none of them developed abscesses. None of the factors we could evaluate from the questionnaire were found to be significantly associated with SSI. SSI after mid-urethral slings rarely occurred in Japan (0.22%) and no parameters about perioperative managements significantly increased SSI. However, further studies with more detail information of each patient and operation are required to confirm their appropriate perioperative managements for mid-urethral slings.

Keywords: Mid-urethral slings; Perioperative management; Questionnaire survey; Stress urinary incontinence; Surgical site infection.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Antibiotic Prophylaxis / statistics & numerical data
  • Epidemiological Monitoring
  • Female
  • Hospitals / statistics & numerical data
  • Humans
  • Japan / epidemiology
  • Perioperative Care / methods
  • Perioperative Care / statistics & numerical data*
  • Retrospective Studies
  • Suburethral Slings / adverse effects*
  • Surgical Wound Infection / epidemiology*
  • Surgical Wound Infection / etiology
  • Surgical Wound Infection / prevention & control
  • Surveys and Questionnaires / statistics & numerical data
  • Urinary Incontinence, Stress / surgery*
  • Urologic Surgical Procedures / adverse effects*
  • Urologic Surgical Procedures / instrumentation


  • Anti-Bacterial Agents