Impact of surgical mask use by scrubbed personnel on postoperative infections in endourology: lessons from the COVID-19 era.

Publication date: Jun 23, 2025

Surgical masks have long been standard in operating rooms to reduce infection risks, though their effectiveness, especially in minimally invasive procedures, has been increasingly questioned. Endourological surgeries present a unique setting where contamination is more likely linked to instrumentation than airborne pathogens. To evaluate whether the routine use of surgical masks by scrubbed personnel reduces postoperative urinary tract infections (UTIs) in endourological procedures. A retrospective cohort study was conducted at a single institution, comparing patient outcomes during two periods: a non-COVID-19 era (no mask use) and a COVID-19 era (universal mask use). A total of 4442 patients who underwent endourological surgery between 2017 and 2024 were included. Data on demographics, perioperative factors, and infection outcomes were analyzed. The overall rate of postoperative UTIs was 2. 3% in the non-mask group and 1. 6% in the mask group (p = 0. 101). Multivariate regression identified longer surgery duration and positive preoperative urine culture as significant predictors of postoperative UTI. Mask usage was not a statistically significant factor. Routine surgical mask use by scrubbed personnel during endourology procedures was not associated with a significant reduction in postoperative UTI rates. These findings suggest that mask mandates in such settings may not contribute meaningfully to infection prevention and warrant reconsideration in the context of evidence-based surgical practice.

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Original Article