Abstract Purpose To identify risk factors for postoperative urinary tract infection (UTI) within 90 days following construction of a urinary diversion, and to assess the association between UTIs and results of renography scans 6–8 weeks postoperatively. Methods A retrospective review of 612 patients who received a urinary diversion with or without radical cystectomy at Rigshospitalet, Denmark between January 2019 and January 2025. The primary outcome was UTI within 90 days after surgery, defined as presence of relevant symptoms, urine culture ≥ 10,000 CFU, and treatment with antimicrobials. Delayed excretion on Tc-99 m-MAG3 renography was defined as documentation thereof in the medical records by a urologist. Cox regression and multivariable logistic regression were performed to identify risk factors. Results A total of 346 UTIs occurred in 242 patients (40%) within 90 days after surgery. Bacteremia was present in 111 (32%) of the UTIs. Cox regression showed that female sex (HR = 1.5), BMI 25–30 kg/m 2 (HR = 1.6), preoperative diabetes (HR = 1.7), orthotopic neobladder (HR = 2.1) or continent cutaneous reservoir (HR = 3.4), and early stent dislodgement (HR = 2.0) were all associated with an increased risk of UTI. On multivariable logistic regression, delayed excretion on postoperative renography was associated with higher UTI rate (OR = 1.7), whereas asymmetrical functional distribution was not (OR = 0.96). Conclusion Postoperative UTI after urinary diversion is common and often complicated by bacteremia. Several risk factors for UTI within 90 days were identified, with the highest HR for continent diversions. Delayed excretion on renography was associated with occurrence of UTI, indicating that UTI is related to postoperative urine obstruction.
Riemann et al. (Tue,) studied this question.