Predictive Risk Factors of Urinary Tract Infection Following Semirigid Ureteroscopic Lithotripsy

Abstract

INTRODUCTION: The aim of this study is to determine the frequency and predictive factors of postoperative UTI in patients who underwent URS regarding ureteral stones. METHODS: Data from 425 patients undergoing semi-rigid ureteroscopic lithotripsy between December 2015 and December 2019 at a single center were reviewed to detect factors predicting postoperative urinary tract infections. RESULTS: Of the 425 patients, 35 were infective (8.2%). Proximal ureteral stones were the majority in infective group (48.5%); distal ureteral stones were the majority in non-infective group (42.6%)(p=0.026). Stone number and stone size were also higher in the postoperative infective group (p<0.05). UTI history and preoperative DJS insertion were higher in Group 1 (p <0.001, p = 0.001, respectively). Multivariate regression analyses revealed that history of UTI (OR=5.513, 95% CI; 2.622–11.591, p value <0.001) and presence of residual fragments (OR=4.274, 95% CI; 1.892–9.657, p value <0.001) were independent risk factors for infectious complications after URS. DISCUSSION AND CONCLUSION: Even if URS is considered an innocuous procedure, the probability of postoperative infectious complications is far from negligible. Our results showed that the presence of UTI history and residual fragments were associated with an increased risk of subsequent UTI after URS. These infectious complications also have significant morbidity, mortality and expenditure if not treated timely. Therefore, to avoid this preventable complication, all variables should be reviewed and more careful.

Early versus delayed ureterolithotripsy following obstructive acute pyelonephritis treatment

“…7 Therefore, it should be known that the factors affecting UTI after ureterolithotripsy, such as UTI history, residual fragments, and comorbidities may differ in this patient group, and different principles should be defined in the treatment of stone removal after APN treatment. 8,9 Stone burden, degree of hydronephrosis, and non-contrast CT findings were similar in patients with early and delayed ureterolithotripsy. Patients who underwent early ureterolithotripsy, during hospitalization after obstructive APN treatment, had a higher postoperative UTI rate compared to patients with delayed ureterolithotripsy (29.4% vs 8.7%, p = 0.045).…”

“…7 Therefore, it should be known that the factors affecting UTI after ureterolithotripsy, such as UTI history, residual fragments, and comorbidities may differ in this patient group, and different principles should be defined in the treatment of stone removal after APN treatment. 8,9…”

Risk factors and economic burden for community-acquired multidrug-resistant organism-associated urinary tract infections: A retrospective analysis

“…[18,19] Globally, UTIs associated with urolithiasis and benign prostatic hyperplasia occur most frequently in India, China, and the Russian Federation. [20] Within the normal and sterile environment of the urinary tract, invasive urologic procedures destroy the barrier effect of the urethral mucosa, and weaken the bladder and urinary tract to the defense of bacteria, therefore exposing the urethra to a potentially contaminated environment in which the bladder may be eroded by bacteria, resulting in a UTI. [20,21] According to the China CRE Network, 214 of 592 patients (36.1%) were treated with 3rd or 4th generation cephalosporins or carbapenems, while 191 (32.3%) received the same classes of antibiotics.…”