Evaluation of the Relationship Between Vaginal and Lower Urinary Tract Microbiomes and Infection After Hysterectomy

Mayo Clinic

Status: Completed

Conditions: Urinary Tract Infection; Hysterectomy; Pelvic Organ Prolapse

Study type: Observational

Funder types: Other

Identifiers

NCT02751073

15-006300

Details and patient eligibility

About

The purpose of this study is to learn more about the microbes (bacteria) that live in the vagina and the bladder. The investigators are doing this research study to understand the relationship between microbes (the microbiome) and the occurrence of urinary tract infection following surgical removal of the uterus and pelvic organ prolapse repair. The investigators expect Lactobacillus and Gardnerella will be the dominant organisms for most women. Non-Lactobacillus dominant microbiome communities will be more common in women who ultimately develop postoperative urinary tract infection.

Full description

The goal of this pilot study is to characterize the presence and stability of the microbial community in the vagina and lower urinary tract in a cohort of 20 postmenopausal women undergoing transvaginal hysterectomy with pelvic reconstruction for pelvic organ prolapse. The investigators intend to collect longitudinal samples in the preoperative, intraoperative, and postoperative time period in order to understand the pervasiveness of the microbes in the vagina and lower urinary tract, and to identify, in a very preliminary way, particular microbes that may be associated with postoperative urinary tract infection.

Enrollment: 25 patients

Sex: Female

Ages: 40+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Postmenopausal females (defined by cessation of menses for one full year)
• Planned surgical correction of pelvic organ prolapse with transvaginal hysterectomy and concomitant pelvic reconstruction for uterovaginal prolapse
• Scheduled surgery date within 4 weeks of study consent
• Physically able to self-collect vaginal swabs and clean-catch urine samples

Exclusion criteria

• Women who are premenopausal, pregnant or nursing
• Currently taking or have taken antibiotics in the past 2 weeks
• History of recurrent urinary tract infections
• History of mesh complications, including erosion/extrusion
• Non-vaginal approach to hysterectomy or prolapse repair