OBJECTIVES: Hospital-acquired catheter-associated urinary tract infections (UTIs) have been regarded as preventable adverse events, yet their risk in endoscopic skull base surgery (ESBS) has not been well described despite common use. We determine the incidence of UTI following ESBS and identify contributing clinical factors. METHODS: Retrospective review was conducted for a cohort of 229 consecutive adult patients who underwent endoscopic endonasal surgery for treatment of any skull base pathology between July 2018 and June 2022 at a tertiary academic skull base surgery program. Postoperative UTI comprised the primary outcome. Independent variables included patient demographics, use and length of urinary catheterization, and pre-existing genitourinary conditions. RESULTS: Nosocomial UTIs were identified in 1.3% (3/229) of patients, occurring on postoperative days 2, 9, and 14, respectively
all were catheter-associated. Overall, 86.0% (197/229) of patients received urinary catheters (mean duration 2.2 ± 1.8 days). Compared to those without, patients with UTI were older (70.0 ± 15.4 vs. 52.2 ± 16.8 years, CONCLUSION: Although UTIs are uncommon in ESBS patients, advanced age, length of stay, duration of indwelling urinary catheterization, and comorbid genitourinary conditions may elevate risk.