Nomogram for predicting risk factors of fever in patients with negative preoperative urine culture after retrograde intrarenal surgery

Qiao, Qing; Hu, Yongtao; Chen, Yang; Yan, Qunsheng; Xu, Yuexian; Liang, Hu; Liang, Chaozhao; Hao, Zongyao

doi:10.1007/s00345-023-04302-5

Cited by 1 publication

(1 citation statement)

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“…One of the most important factors in protection against infectious complications is a negative preoperative urine culture. However, even if preoperative urine culture is negative in patients undergoing RIRS, postoperative fever has been reported at the rate of 14.6% [ 4 ]. In the endourological treatment of kidney stones, stone and renal pelvis culture has been found to have higher efficacy in the prediction of infectious complications than mid-flow urine culture, and even if preoperative mid-flow urine culture is negative, the complication rates are increased if there is bacterial production in stone or renal pelvis culture [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

A new protocol for renal collecting system sterilization with antibiotic irrigation during lithotripsy in retrograde intrarenal surgery: a prospective, comparative study

Yildiz,

Bayraktar,

Kacan

et al. 2024

World J Urol

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Purpose To present a new protocol using antibiotic irrigation during lithotripsy in retrograde intrarenal surgery (RIRS) to provide sterility of the renal collecting system. Methods This prospective study included 102 patients who underwent RIRS between January 2022 and August 2023. The patients were examined in two groups as those who received antibiotic irrigation (n:51) and standard irrigation (n:51). In the antibiotic irrigation group, 80 mg of gentamicin was dissolved in normal saline in a 3 L irrigation pouch to obtain a 26.7 mg/L concentration. In the standard irrigation group, normal saline was used. Preoperative information, including age, sex, body mass index (BMI), ASA score, stone side, volume, and density, and the Seoul National University Renal Stone Complexity (S-ReSC) score. The groups were compared with respect to postoperative fever (> 38 °C), urinary tract infection (UTI), systemic inflammatory response syndrome (SIRS), infectious complications such as sepsis, and stone-free rate. Results No statistically significant difference was determined between the groups with respect to age, sex, BMI, ASA score, stone side, volume and density, and S-ReSC score (p > 0.05 for all). Statistically significant differences were determined between the groups with respect to postoperative fever (p = 0.05), SIRS (p = 0.05), and hospital length of stay (p = 0.05). Sepsis was observed in one patient in the standard irrigation group and in none of the antibiotic irrigation group. Conclusion The reliability, efficacy, and utility of antibiotic irrigation during lithotripsy in RIRS were presented in this study as a new protocol for sterilization of the renal collecting system which will be able to reduce infectious complications.

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Section: Introductionmentioning

confidence: 99%