Urogenital Tract Infection

Effect of Residual Stone Fragments on Patient-Reported Quality of Life after Endoscopic Kidney Stone Surgery: Sang Hee Lee, Jun-Koo Kang, Jae-Wook Chung, Yun-Sok Ha, Jun Nyung Lee, Seock Hwan Choi, Hyun Tae Kim, Tae-Hwan Kim, Eun Sang Yoo, Tae Gyun Kwon, Bum Soo Kim; Urogenit Tract Infect 2024;19(2):31-39. Published online August 31, 2024; DOI: https://doi.org/10.14777/uti.2024.19.2.31

Abstract PDF PubReader ePub: Purpose: This study examined the effects of residual fragments (RF) on the patient-reported quality of life (QOL) after kidney stone surgery, such as retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL), using the Korean version of the Wisconsin Stone Quality of Life Questionnaire (K-WISQOL).
Materials and Methods: The medical records of 156 patients who underwent RIRS or PCNL and completed the preoperative and postoperative K-WISQOL from January 2021 to September 2023 were analyzed retrospectively. The patients were divided into RIRS and PCNL groups by the surgical method. The participants completed the K-WISQOL within four weeks before and after treatment. The patients’ baseline characteristics, surgical outcomes, and K-WISQOL scores were compared according to the presence of RF in each surgical group.
Results: Of the 156 patients, 95 underwent RIRS, and 61 underwent PCNL. In the RIRS group, the patients’ baseline characteristics and surgical outcomes were similar in the stone-free (SF) and RF subgroups. The changes in all K-WISQOL domain scores and total scores were similar in the two subgroups. In the PCNL group, the RF subgroup had a significantly higher proportion of staghorn stones, a significantly larger mean stone diameter and significantly longer operation time than those of the SF subgroup. But, the changes in all K-WISQOL domain scores and total scores were not significantly different between the two subgroups, as observed in the RIRS group.
Conclusions: This study showed that the presence of RFs after endoscopic kidney surgery did not affect the short-term patient-reported QOL regardless of the surgical methods.

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Risk Factors for Sepsis after Retrograde Intrarenal Surgery: Single Center Experience: Jinseok Kang, Koo Han Yoo, Taesoo Choi, Gyeong Eun Min, Dong-Gi Lee, Hyung-Lae Lee, Jeonghyouk Choi; Urogenit Tract Infect 2023;18(3):93-100. Published online December 31, 2023; DOI: https://doi.org/10.14777/uti.2023.18.3.93

Purpose: To evaluate risk factors for sepsis after retrograde intrarenal surgery for treatment of renal stones.
Materials and Methods: We analyzed the clinical data of 243 patients with kidney stones who visited our institution between April 2017 and April 2023. Age, sex, body mass index, underlying disease, location and size of stones, previous history of stones, previous history of urinary tract infections, duration of surgery, preoperative drainage, application of ureteral balloon dilation, and laboratory test results were included in the analysis.
Results: The mean age of the patients was 58.4 (±15.0) years; there were more men (53.1%) than women (46.9%). Of the 243 patients, the overall rate of sepsis was 5.8% (n=14) and the total mortality rate was 0.4% (n=1). In univariate analysis, history of urinary tract infection (p=0.019), positive preoperative urine culture test (p=0.009), operative duration of more than 90 min (p=0.004), and application of ureter balloon dilation (p=0.016) were statistically significant. In multivariate analysis, positive finding in the urine culture test performed before surgery (p=0.003), operation duration >90 min (p=0.005), and use of balloon dilation during surgery (p=0.011) were statistically significant.
Conclusions: There is a risk of progression to postoperative sepsis if bacteria are detected in the urine culture before surgery, if the operative time exceeds 90 min, or if balloon dilation is performed during surgery. Given that the probability of progression to sepsis is approximately 6%, close observation and active treatment are needed for patients with these risk factors.

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Analysis of postoperative infection factors of retrograde intrarenal surgery combined with negative pressure equipment for renal stones
Deheng Cui, Qinghong Ma, Qiuyan Zhang, Lian Zhang, Guoqiang Chen
Scientific Reports.2024;[Epub] CrossRef

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Is Preoperative Pyuria Associated with Postoperative Febrile Complication after Ureteroscopic Ureter or Renal Stone Removal?: Seungsoo Lee; Urogenit Tract Infect 2020;15(1):1-5. Published online April 30, 2020; DOI: https://doi.org/10.14777/uti.2020.15.1.1

Abstract PDF PubReader ePub: Purpose: The association between preoperative pyuria and postoperative febrile complications after ureteroscopic ureter or renal stone removal was examined.
Materials and Methods: From June 2014 to July 2016, 110 patients who underwent ureteroscopic ureter or renal stone removal by a single surgeon were evaluated. The patients were categorized as the “pyuria group” and “nonpyuria group.” The sex, age, stone laterality, stone location, stone size, preoperative urine culture results, and postoperative complications in each group were analyzed.
Results: The pyuria and nonpyuria groups were comprised of 55 patients each. The mean ages the pyuria and nonpyuria groups were 58.4±16.1 years and 54.4±13.2 years, respectively. There were respectively, 43 and 12 unilateral and bilateral stones in the pyuria group, and 53 and two in the nonpyuria group. The stone sizes of the pyuria and nonpyuria groups were 13.1±5.4 mm and 11.1±4.7 mm, respectively. The pyuria group contained more patients with bilateral stones and larger stones than the nonpyuria group. Five and two postoperative febrile complications were encountered in the pyuria group and the nonpyuria group, respectively. No significant difference in febrile complications was observed between the two groups. In logistic regression analysis, bilateral stones and larger stones were associated with pyuria.
Conclusions: In ureteroscopic stone removal surgery, preoperative pyuria was associated with bilateral and larger stones, but there were no associations with febrile complications.

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