The significance of intraoperative renal pelvic urine and stone cultures for patients at a high risk of post-ureteroscopy systemic inflammatory response syndrome

Yoshida, Satoshi; Takazawa, Ryoji; Uchida, Yusuke; Kohno, Yusuke; Waseda, Yuma; Tsujii, Toshihiko

doi:10.1007/s00240-019-01112-6

Cited by 25 publications

(15 citation statements)

References 16 publications

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“…Bedridden status corresponds to frailty, which is independently associated with adverse outcomes 19 . In the current study, the incidence of SIRS was actually higher (22%) than that of our entire cohort (9.6%) reported previously 20 . Moreover, BSI was considered to be another representative index, since it would appear during an infective exacerbation.…”

Section: Discussioncontrasting

confidence: 76%

Successful outcomes of endoscopic lithotripsy in completely bedridden patients with symptomatic urinary calculi

Waseda

Takazawa

Kobayashi

et al. 2020

Sci Rep

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Due to the aging population, the number of completely bedridden individuals is expected to increase, and such individuals are at high risk of developing urinary calculi. This retrospective study included 32 consecutive bedridden patients, who had undergone endoscopic lithotripsy between 2010 and 2019, and aimed to identify the treatment outcomes of endoscopic lithotripsy for bedridden patients. A total of 45 endoscopic lithotripsies were performed to treat stones (median cumulative diameter, 24 mm). The stone-free rate (SFR) < 4 mm and complete SFR (0 mm) were achieved in 81% and 63% of patients, respectively. Postoperatively, 10 patients (22%) developed symptoms of systemic inflammatory response syndrome, and three patients (7%) had bloodstream infections. Except for one patient (3%) having a retained ureteral stent ultimately died from septic shock, drainage tube-free discharge was achieved in all patients. The 2-year cumulative incidence of stone-related events, and overall mortality rate, were 18% and 27%, respectively. Endoscopic lithotripsy is well tolerated and is associated with a high success rate, even with severe comorbidities and a relatively large stone burden. physicians should consider performing endoscopic lithotripsy in bedridden patients with symptomatic urinary calculi regardless of their relatively short life expectancy and the remote risk of perioperative mortality.

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Section: Discussioncontrasting

confidence: 76%

Successful outcomes of endoscopic lithotripsy in completely bedridden patients with symptomatic urinary calculi

Waseda

Takazawa

Kobayashi

et al. 2020

Sci Rep

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“…SULL is an effective surgical method with high stone-free rate for treating ureteral stones, yet infectious complications are inevitable (6,7). Infectious complications following URS may lead to an extended period of hospital stay with an impact on the prognosis of patients, increasing the potential risk for multiple organ dysfunction (7)(8)(9). As a result, it is important to prevent infection-related complications in order to minimize morbidity rates.…”

Section: Discussionmentioning

confidence: 99%

“…The common message of all the studies, however, is that intraoperative cultures may be crucial for guidance on antibiotic treatment postoperatively. In a study exploring the association of RPUC and SC with SIRS following URS, it was stated that PBUC was incompatible with RPUC and SC (9). Reconsideration of the antibiotic therapy according to the results of the RPUC and SC was recommended in cases of postoperative infectious complications (9).…”

Section: Discussionmentioning

confidence: 99%

“…In a study exploring the association of RPUC and SC with SIRS following URS, it was stated that PBUC was incompatible with RPUC and SC (9). Reconsideration of the antibiotic therapy according to the results of the RPUC and SC was recommended in cases of postoperative infectious complications (9). Nevertheless, in the current study, 20 out of 23 patients with SIRS had PBUC, RPUC or SC growth, and PBUC, RPUC and SC were observed to be compatible in eight (40 %) patients.…”

Section: Discussionmentioning

confidence: 99%

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The effect of the duration between urine culture and semirigid ureteroscopic on the rate of systemic inflammatory response syndrome postoperatively

Akkaş¹,

Şam²,

Cinislioğlu³

et al. 2021

Preprint

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Purpose: The aim of this study is to analyze the preoperative and intraoperative factors that might induce systemic inflammatory response syndrome after semirigid ureteroscopic lithotripsy (SULL) , and to evaluate the impact of duration between preoperative bladder urine culture (PBUC) and surgery on postoperative systemic inflammatory response syndrome (SIRS). Methods: A retrospective review was conducted including patients who underwent SULL in our center between January 2011 and June 2020. Prior to surgery, PBUC were obtained from all patients and postoperatively patients were observed for signs of SIRS. Univariable and multivariable binary logistic regression analysis were implemented to demonstrate the factors that predict SIRS postoperatively. Results: The entire study included a cohort of 572 patients. The rate of SIRS following SULL was 1.7%. Predictive factors for SIRS were listed as stone volume, surgical time, and history of recurrent urinary tract infection. No significant difference was detected in terms of the duration between PBUC and SULL when comparing the SIRS group with the other group. Conclusion: The duration between PBUC and SULL is not an efficacious factor for SIRS. It may be useful to conduct prospective studies to enlighten this issues as endourologists deal with this duration dilemma often in daily practice. Keywords: Semirigid ureteroscopic lithotripsy, Systemic inflammatory response syndrome, Preoperative bladder urine culture

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“…The results of the PBUC susceptibility test do not correlate well with the results of renal pelvic urine culture (RPUC) analysis [4]. It has been demonstrated that growth in RPUC is an important marker for infection development after endoscopic operations [5]. Despite antibiotic treatment or PAP, growth may occur in cultures taken intraoperatively, or postoperative urinary tract infection may develop depending on factors such as obstruction and antimicrobial resistance in the urinary system [6].…”

Section: Introductionmentioning

confidence: 99%

Should renal pelvic urine culture be obtained routinely in flexible ureterorenoscopy?

Koraş¹,

Yarımoğlu²,

Polat³

et al. 2021

Preprint

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Background: Preoperative bladder urine culture (PBUC) analysis has become a standard application before any stone surgery. When growth is detected in PBUC, it is contraindicated to perform flexible ureterorenoscopy (f-URS). The results of the PBUC susceptibility test do not correlate well with those of the renal pelvic urine culture (RPUC) analysis. Previous studies have demonstrated the positivity of RPUC as an important marker for the development of infections after endoscopic operations. In the current study, we aimed to evaluate the consistency between PBUC and RPUC and to identify preoperative markers associated with a positive RPUC. Methods: Data from 129 patients who underwent f-URS on renal and proximal ureteral stones in two centers between 2015 and 2020 were prospectively recorded in a database and retrospectively analyzed. PBUC was obtained from all the patients preoperatively, and RPUC was taken at the beginning of the f-URS operation. The results of the two cultures were compared. Results: There was growth in PBUC in 25 (19.4%) patients and RPUC in 35 (27.1%) patients. Possible predictive markers in predicting a positive RPUC were evaluated using multivariate logistic regression analysis. Preoperative urine density at the renal pelvis [odds ratio (OR): 0.848, p<0.001],grade≥2 hydronephrosis (OR:18.970,p=0.001), and lower calyceal stone localization (OR:0.033,p=0.017) were determined as independent predictive factors for a positive RPUC. The ability of pelvis urine density to predict positive RPUC positivity was evaluated using the receiver operating characteristic analysis, in which the area under the curve value was determined to be 0.858 (0.780-0.936). The cut-off value of pelvis urine density in the prediction of RPUC positivity was 4.5, at which it had 80% sensitivity and 77.7% specificity. Conclusions: PBUC may not represent true colonization. Although bladder urine culture is negative before the operation, patients with preoperative hydronephrosis and low pelvis urine density may have RPUC growth.

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The significance of intraoperative renal pelvic urine and stone cultures for patients at a high risk of post-ureteroscopy systemic inflammatory response syndrome

Cited by 25 publications

References 16 publications

Successful outcomes of endoscopic lithotripsy in completely bedridden patients with symptomatic urinary calculi

Successful outcomes of endoscopic lithotripsy in completely bedridden patients with symptomatic urinary calculi

The effect of the duration between urine culture and semirigid ureteroscopic on the rate of systemic inflammatory response syndrome postoperatively

Should renal pelvic urine culture be obtained routinely in flexible ureterorenoscopy?

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