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- 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
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Abstract
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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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- 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
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Abstract
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- 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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