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Factors for predicting early infection after retrograde intrarenal surgery (RIRS) in 1-2 cm renal stones
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  • Huseyin Kazan,
  • Mehmet Caglar Cakici,
  • Ferhat Keser,
  • Meftun Culpan,
  • Ozgur Efiloglu,
  • Asif Yildirim,
  • Gökhan Atış
Huseyin Kazan
Istanbul Medeniyet University
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Mehmet Caglar Cakici
Istanbul Medeniyet University
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Ferhat Keser
Istanbul Medeniyet University
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Meftun Culpan
Istanbul Medeniyet University
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Ozgur Efiloglu
Istanbul Medeniyet University
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Asif Yildirim
Istanbul Medeniyet University
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Gökhan Atış
Istanbul Medeniyet University
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Abstract

Objective: To investigate the factors, especially preoperative urinalysis, predicting postoperative early infection after retrograde intrarenal surgery (RIRS) in 1-2 cm renal stones. Methods: Of the 642 patients who underwent RIRS between September 2013 and July 2019, 289 patients with a total stone size of 1-2 cm were included in the study. Patients were divided into two groups as with and without postoperative urinary tract infection. The demographic data and perioperative findings of all patients were retrospectively reviewed. Sterile urine cultures were obtained in all patients during the preoperative 30-day period and urine analysis values were included in the data. Results: Urinary system infection (UTI) was seen in 20 (6.9%) of 289 patients. Patient demographics were similar between groups. There was no statistically significant difference between the two groups in terms of stone diameter and stone localization (median diameter 13.5 vs 15, p=0.285). Patients with postoperative UTI had a higher rate of UTI history (55% vs 20.5%, p=0.000) and longer operative times (62.5 vs 60 min., p=0.008). Rate of pyuria, leukocyte esterase and nitrite positivity were observed more frequently in patients with postoperative UTI. In multivariate analysis, UTI history, prolonged operative time, and nitrite positivity were found to be independent risk factors for postoperative UTI. Conclusion: Nitrite positivity in preoperative urinanalysis, history of UTI and prolonged operation time are the factors that predict the postoperative infection in RIRS for stones between 1-2 cm.

Peer review status:Published

Jul 2020Published in European Urology Open Science volume 19 on pages e1873-e1875. 10.1016/S2666-1683(20)33864-7