Urinary Tract Infection After Robot-assisted Laparoscopic Pyeloplasty: Are Urine Cultures and Antibiotics Helpful?

Chan, Yvonne Y.; Rosoklija, Ilina; Shannon, Rachel; Singal, Ashima; D’Oro, Anthony; Meade, Patrick; Gong, Edward M.; Lindgren, Bruce W.; Johnson, Emilie K.

doi:10.1016/j.urology.2020.09.054

Cited by 8 publications

(3 citation statements)

References 18 publications

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Section: Resultsmentioning

confidence: 99%

“…Pooled results from three observational studies showed no significant benefits from continuing antibiotic prophylaxis after pyeloplasty in terms of recurrent UTIs (pooled RR: 1.22; 95% CI: 0.74-2.00) [69][70][71] [Table 11]. Two of the included studies enrolled more than 800 children undergoing pyeloplasty, and all of these children had a stent placed after surgery [69,70].…”

Section: Which Dosage Should Be Preferred For Continuous Antibiotic P...mentioning

confidence: 99%

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Antibiotic Prophylaxis for the Prevention of Urinary Tract Infections in Children: Guideline and Recommendations from the Emilia-Romagna Pediatric Urinary Tract Infections (UTI-Ped-ER) Study Group

Autore,

Bernardi,

Ghidini

et al. 2023

Antibiotics

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Background: Urinary tract infection (UTI) represents one of the most common infectious diseases and a major cause of antibiotic prescription in children. To prevent recurrent infections and long-term complications, low-dose continuous antibiotic prophylaxis (CAP) has been used. However, the efficacy of CAP is controversial. The aim of this document was to develop updated guidelines on the efficacy and safety of CAP to prevent pediatric UTIs. Methods: A panel of experts on pediatric infectious diseases, pediatric nephrology, pediatric urology, and primary care was asked clinical questions concerning the role of CAP in preventing UTIs in children. Overall, 15 clinical questions were addressed, and the search strategy included accessing electronic databases and a manual search of gray literature published in the last 25 years. After data extraction and narrative synthesis of results, recommendations were developed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) methodology. Results: The use of CAP is not recommended in children with a previous UTI, with recurrent UTIs, with vesicoureteral reflux (VUR) of any grade, with isolated hydronephrosis, and with neurogenic bladder. CAP is suggested in children with significant obstructive uropathies until surgical correction. Close surveillance based on early diagnosis of UTI episodes and prompt antibiotic therapy is proposed for conditions in which CAP is not recommended. Conclusions: Our systematic review shows that CAP plays a limited role in preventing recurrences of UTI in children and has no effect on its complications. On the other hand, the emergence of new antimicrobial resistances is a proven risk.

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Section: Resultsmentioning

confidence: 99%

Section: Which Dosage Should Be Preferred For Continuous Antibiotic P...mentioning

confidence: 99%

Antibiotic Prophylaxis for the Prevention of Urinary Tract Infections in Children: Guideline and Recommendations from the Emilia-Romagna Pediatric Urinary Tract Infections (UTI-Ped-ER) Study Group

Autore,

Bernardi,

Ghidini

et al. 2023

Antibiotics

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“…The results revealed that preoperative UTI was a risk factor for the recurrence of UPJO. Meanwhile, other researchers also proposed that infection was an important reason for the failure of the initial operation of UPJO ( 40 , 41 ), which may be related to anastomotic adhesion caused by infection ( 42 ). However, it was also confirmed that the administration of antibiotics ( 43 , 44 ) was not effective in preventing UTI after the surgical treatment of UPJO.…”

Section: Discussionmentioning

confidence: 99%

The construction of a nomogram to predict the prognosis and recurrence risks of UPJO

Ma,

Gao,

Chang

et al. 2024

Front. Pediatr.

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ObjectiveThis study was conducted to explore the risk factors for the prognosis and recurrence of ureteropelvic junction obstruction (UPJO).MethodsThe correlation of these variables with the prognosis and recurrence risks was analyzed by binary and multivariate logistic regression. Besides, a nomogram was constructed based on the multivariate logistic regression calculation. After the model was verified by the C-statistic, the ROC curve was plotted to evaluate the sensitivity of the model. Finally, the decision curve analysis (DCA) was conducted to estimate the clinical benefits and losses of intervention measures under a series of risk thresholds.ResultsPreoperative automated peritoneal dialysis (APD), preoperative urinary tract infection (UTI), preoperative renal parenchymal thickness (RPT), Mayo adhesive probability (MAP) score, and surgeon proficiency were the high-risk factors for the prognosis and recurrence of UPJO. In addition, a nomogram was constructed based on the above 5 variables. The area under the curve (AUC) was 0.8831 after self cross-validation, which validated that the specificity of the model was favorable.ConclusionThe column chart constructed by five factors has good predictive ability for the prognosis and recurrence of UPJO, which may provide more reasonable guidance for the clinical diagnosis and treatment of this disease.

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Retrograde stent with external string for pediatric robotic pyeloplasty: does it reduce cost and complications?

et al. 2022

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Urinary Tract Infection After Robot-assisted Laparoscopic Pyeloplasty: Are Urine Cultures and Antibiotics Helpful?

Cited by 8 publications

References 18 publications

Antibiotic Prophylaxis for the Prevention of Urinary Tract Infections in Children: Guideline and Recommendations from the Emilia-Romagna Pediatric Urinary Tract Infections (UTI-Ped-ER) Study Group

Antibiotic Prophylaxis for the Prevention of Urinary Tract Infections in Children: Guideline and Recommendations from the Emilia-Romagna Pediatric Urinary Tract Infections (UTI-Ped-ER) Study Group

The construction of a nomogram to predict the prognosis and recurrence risks of UPJO

Retrograde stent with external string for pediatric robotic pyeloplasty: does it reduce cost and complications?

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