Urogenital Tract Infection

Intraoperative Factors Associated With Postoperative Febrile Infectious Complications Following Retrograde Intrarenal Surgery: A Propensity Score-Matched Study: Wonjong Yang, Sangyong Park, Hee Sub Lee, Youngrak Jeong, Wonchul Lee, Hyung-Jee Kim, Seong Ho Lee, Justin Lee, Jong Keun Kim; Urogenit Tract Infect 2026;21(2):125-135. Published online August 31, 2026; DOI: https://doi.org/10.14777/uti.2652028.014

Abstract PDF PubReader ePub: Purpose
To investigate the intraoperative factors associated with postoperative febrile infectious complications following retrograde intrarenal surgery (RIRS). Materials and Methods: A total of 352 patients who underwent RIRS for renal stones between March 2017 and December 2022 were included in the analysis. Preoperative factors included age, sex, body mass index, underlying diseases, preoperative urine analysis results, and stone characteristics on computed tomography scans. Patients were divided into 2 groups based on the presence (group B) or absence (group A) of postoperative febrile infectious complications. Intraoperative factors—such as the degree of hydronephrosis on retrograde pyelography (RGP), stone impaction on endoscopic findings, size of the ureteral access sheath (UAS), grade of ureteral wall injury, operation time, and stone composition—were compared retrospectively.
Results
Postoperative febrile infectious complications occurred in 44 patients (12.6%). Following 1:3 propensity score matching, preoperative factors were analyzed for 44 patients (group B) and 132 patients (group A). Group B had a significantly longer hospital stay than group A (p=0.007); however, no significant differences were observed in postoperative pain (p=0.862) or stone-free rate (p=0.197). Hydronephrosis (odds ratio [OR], 7.31; 95% confidence interval [CI], 2.65–20.19) and high-grade ureteral wall injury (OR, 4.15; 95% CI, 1.88–9.12) were independently associated with postoperative febrile infectious complications, whereas no significant associations were observed for stone impaction, UAS size, operation time, or infectious stone composition.
Conclusions
Hydronephrosis identified on RGP and high-grade ureteral wall injury during RIRS were associated with postoperative febrile infectious complications and may serve as potential markers for risk stratification.

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Role of Presepsin as a Predictive Factor for Sepsis in Patients With Urinary Tract Infection Associated With Ureteral Calculi: A Retrospective Cohort Study: Jong Gyun Ha, Hee Chang Jung, Yeong Uk Kim; Urogenit Tract Infect 2026;21(2):89-95. Published online August 31, 2026; DOI: https://doi.org/10.14777/uti.2652014.007

Abstract PDF PubReader ePub: Purpose
Recently, multiple studies have reported presepsin as a useful inflammatory biomarker for early sepsis diagnosis in patients with urinary tract infections (UTIs). Nonetheless, few studies have evaluated the efficacy of presepsin in urosepsis associated with ureteral calculi. We retrospectively investigated the efficacy of presepsin for early urosepsis diagnosis associated with ureteral calculi. Materials and Methods: Between May 2021 and July 2023, 64 patients with UTI associated with ureteral calculi were included. Sepsis was defined as a Sequential Organ Failure Assessment (SOFA) score increase of ≥2 points. Patients were divided into 2 groups, with (n=38) and without (n=26) sepsis, and we assessed clinical characteristics (age, sex, and past medical history), laboratory data, and stone characteristics. Additionally, we evaluated predictive factors for urosepsis associated with ureteral calculi and compared these factors with inflammatory biomarkers.
Results
The proportion of females in the sepsis and nonsepsis groups was 89.5% (n=34) and 61.5% (n=16), respectively. In univariable analysis, low albumin level, low platelet count, and presepsin and procalcitonin (PCT) levels correlated with sepsis (p<0.05). In univariable logistic regression analysis, quick SOFA (odds ratio [OR], 2.071; p=0.033), C-reactive protein (CRP; OR, 1.08; p=0.01), PCT (OR, 1.025; p=0.008), and presepsin (OR, 1.354; p=0.001) were significantly associated with sepsis. In multivariate logistic regression analysis, presepsin (OR, 1.321; p=0.003) was significantly associated with sepsis. In receiver operating characteristic curve analysis of inflammatory markers, the areas under the curve for CRP, PCT, and presepsin were 0.704, 0.777, and 0.814, respectively.
Conclusions
Elevated presepsin levels may help predict sepsis occurrence in patients with UTI associated with ureteral calculi, thereby supporting timely and appropriate intervention.

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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

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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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COMPARISON OF THE QUALITY OF LIFE IN PATIENTS WITH RENAL CALCULI UP TO 2 CM IN DIAMETER AFTER PERCUTANEOUS NEPHROLITHOTOMY AND RETROGRADE INTRARENAL SURGERY
Ostap-Borys Khudysh, Oleg Nikitin, Andriy Kost, Mykola Chaplia, Andriy Borzhiyevskyy
Proceeding of the Shevchenko Scientific Society. Medical Sciences.2026;[Epub] CrossRef
Percutaneous nephrolithotripsy in treatment of residual calyceal stones
V. V. Dutov, M. Т.S. Dadashov, S. V. Dutov
Urology Herald.2026; 14(3): 144. CrossRef

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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

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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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Establishing an AI-based artifact correction system for intrarenal pressure monitoring using the LithoVue™ Elite ureteroscope: an EAU endourology and AUSET collaboration
Takahiro Yanase, Shuzo Hamamoto, Rei Unno, Steffi Kar Kei Yuen, Vineet Gauhar, Bhaskar K. Somani, Olivier Traxer, Yuya Sasaki, Ryosuke Chaya, Atsushi Okada, Kazumi Taguchi, Takahiro Yasui
World Journal of Urology.2025;[Epub] CrossRef
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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