Cranberry after Midurethral Sling Procedures

Thursday, October 5, 2023

11:18 AM – 11:22 AM US PST

Location: A105-106

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Image Label: Figure 1: Kaplan Meier Per Protocol Analyses (PP)

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Image Label: Figure 2: Kaplan Meier Plot Intent to Treat Analysis (ITT) (n=130)

Presenting Author(s)

Gini Ikwuezunma, MD, MSCR

Female Pelvic Medicine and Reconstructive Surgery Fellow
Oklahoma University Health Science Center
Oklahoma City, Oklahoma, United States

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Co-Author(s)

HW

Halei Wong, MD, MSCR

Assistant Professor
Wright State University College of Medicine
Fairborn, Ohio, United States
LD

Linh Do, MD

Female Pelvic Medicine and Reconstructive Surgery Fellow
University of Oklahoma Health Sciences Center
Richmond, Texas, United States
Josephine Doo, MD (she/her/hers)

Female Pelvic Medicine and Reconstructive Surgery Fellow
Oklahoma University Health Sciences Center
Oklahoma city, Oklahoma, United States
AH

Adam Hare, MD

Assistant Professor, Female Pelvic Medicine and Reconstructive Surgery
Oklahoma University Health Sciences Center
Oklahoma City, Oklahoma, United States
JP

Jennifer Peck, PhD

Professor and Vice Chair, Biostatistics and Epidemiology
Oklahoma University Health Sciences Center
Oklahoma City, Oklahoma, United States
LQ

Lieschen Quiroz, MD

Professor & Section Chief, Female Pelvic Medicine and Reconstructive Surgery
University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma, United States

Disclosure(s):

Gini Ikwuezunma, MD, MSCR: No financial relationships to disclose

Halei Wong, MD, MSCR: No financial relationships to disclose

Linh Do, MD: No financial relationships to disclose

Josephine Doo, MD: No financial relationships to disclose

Adam Hare, MD: No financial relationships to disclose

Jennifer Peck, PhD: No financial relationships to disclose

Lieschen Quiroz, MD: No financial relationships to disclose

Introduction: The risk of urinary tract infection (UTI) following mid-urethral sling (MUS) is reported to be as high as 34%.

Objective: The goal of this study is to evaluate the efficacy of proanthocyanins (PACs) from cranberry extract in preventing UTIs following MUS procedures.

Methods: We recruited patients from a single tertiary care center from February 2020 to December 2022. Eligible patients were planning MUS for the treatment of urinary incontinence. Participants were randomized to receive daily 36mg capsule of PACs during the six weeks following their sling procedure or placebo. The primary endpoint was the proportion of patients diagnosed and treated for UTI compared to placebo. A modified intention-to-treat analysis was performed after excluding participants who did not meet eligibility criteria or withdrew consent.

Results: Of the 141 patients enrolled, 131 completed the study and 16(12.2%) were treated for a UTI in the first six weeks after MUS. There was no difference in UTI treatment between groups at 6 weeks post-op (7 in placebo group [10.8%] vs 9 in cranberry group [13.6%], p= 0.62). There was no difference in the time to onset of UTI symptoms between the treatment groups (p = 0.74). The frequency of UTI symptoms was 24.6% in placebo and 25.8% in cranberry groups RR 0.96, 95% CI [0.53 – 1.73].

Conclusion: In this population. The addition of a cranberry supplement did not have a benefit in preventing postoperative UTIs after MUS.