Post-Percutaneous Nephrolithotomy Systemic Inflammatory Response: A Prospective Analysis of Preoperative Urine, Renal Pelvic Urine and Stone Cultures

Abstract

Even appropriately treated preoperative urinary infections may not prevent infected urine at percutaneous nephrolithotomy. Renal pelvic urine and stone cultures may be the only way to identify the causative organism and direct antimicrobial therapy. We recommend collecting pelvic urine and stone cultures to identify the offending organism in patients at risk for sepsis, particularly those with a large stone burden requiring multiple access tracts.

Contributing Factors for Fever After Tubeless Percutaneous Nephrolithotomy

“…Longer operation time contributing to the development of post-PCNL UTI has been reported by Gonen et al, 16 but other studies demonstrated that there is no statistical difference between operation time and UTI. 13,17 In our study, the operation time in patients who experienced fever attacks after tubeless PCNL was not statistically significantly longer than in patients without fever. Patients with a positive intraoperative stone culture result tended to have post-PCNL fever as reported by Gonen et al in 2008.…”

“…Patients with a positive intraoperative stone culture result tended to have post-PCNL fever as reported by Gonen et al in 2008. 16 Lojanapiwat 17 in 2011 revealed that the collection of intraoperative pelvic urine and stone bacterial cultures is helpful for identifying the offending organism in patients at risk for sepsis. 17 Intraoperative pelvis urine culture was not routinely performed during our practice, and our data suggested that a positive stone bacterial culture result is not a contributing factor for the development of fever after tubeless PCNL.…”

Systemic Inflammatory Response Syndrome After Flexible Ureteroscopic Lithotripsy: A Study of Risk Factors

“…In addition, SIRS has clear specific diagnostic criteria rather than urosepsis, thence to be an important index in evaluating infection related complications in PCNL and FUL procedures. The reported incidence of SIRS after PCNL ranges form 16.7% to 23.4% [3,5], and the risk factors for SIRS following PCNL have been well evaluated in previous studies [4][5][6][7], however, the risk factors for SIRS after FUL are not well understood exactly. To our knowledge, this is the first report in literature that focuses on the post-FUL SIRS, specifically to evaluate the risk factors.…”

Predictive Value of Leukocytosis for Infectious Complications After Percutaneous Nephrolithotomy

“…It is previously reported by several authors that stone size, operative time, positive stone culture, positive pelvic urine culture, and multiple punctures are associated with post-PCNL infectious complications. [12][13][14][15][16] In a recent study, leukocytosis was not found to be associated with any of these predisposing factors.…”