Risk Factors Predicting Urinary Tract Infection Following Semirigid Ureteroscopic Lithotripsy

Abstract

Objective: The aim of this study is to determine the frequency and predictive factors of postoperative UTI in patients who underwent URS because of ureteral stones.Method: 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 the infective group (48.5%), and distal ureteral stones were the majority in the non-infective group (42.6%) (p=0.026). Numbers and size of the stones were also higher in the postoperative infective group (p<0.05). History of UTI and preoperative insertion of DJS were more frequently encountered 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.Conclusion: Even if URS is considered a minimally invasive 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 one should be more careful.