Vulvar re-antisepsis and urinary tract infection after CO2 cystoscopy in laparoscopic hysterectomy

Objective: To evaluate whether vulvar re-antisepsis before carbon dioxide (CO 2 ) cystoscopy after laparoscopic hysterectomy is associated with a lower incidence of postoperative urinary tract infection (UTI). Materials and Methods:This prospective observational study included 98 women who underwent laparoscopic hysterectomy between November 25, 2025, and March 1, 2026.All patients received routine preoperative abdominal and vulvovaginal preparation with 10% povidone-iodine.According to routine intraoperative practice and surgeon preference, 53 patients underwent standard antisepsis alone, and 45 received additional vulvar and periurethral re-antisepsis immediately before CO 2 cystoscopy.The primary outcome was a postoperative UTI, defined according to Centers for Disease Control and Prevention/National Healthcare Safety Network criteria.Logistic regression was used to explore factors associated with postoperative UTI.The study was registered at clinicaltrials.gov(NCT07232446).Results: Postoperative UTI occurred in 8 patients (15.1%) in the standard antisepsis group and in 4 patients (8.9%) in the re-antisepsis group (p=0.538).Vulvar re-antisepsis was not associated with postoperative UTI in the exploratory multivariable model [adjusted odds ratio (OR)=0.89,95% confidence interval (CI): 0.19-4.23;p=0.881].Delayed catheter removal (>6 hours) was associated with postoperative UTI (adjusted OR=12.87,95% CI: 2.13-77.62;p=0.005).Conclusion: Vulvar re-antisepsis before CO 2 cystoscopy did not result in a statistically significant reduction in postoperative UTIs.Given the limited number of events and the non-randomized design, these findings should be interpreted as exploratory.