Urogenital Tract Infection

Original Articles

Predictor for Ureteral Stent Removal in Gynecological Cancer Patients with a Ureteral Obstruction: Sung Hyun Ji, Young Kwon Hong, Young Dong Yu, Seung-Ryeol Lee; Urogenit Tract Infect 2022;17(3):103-109. Published online December 31, 2022; DOI: https://doi.org/10.14777/uti.2022.17.3.103

Abstract PDF PubReader ePub: Purpose: This study investigated the possibility of ureteral stent removal in patients with gynecological cancer and ureteral obstruction.
Materials and Methods: From February 2010 to March 2022, the records of 121 patients with gynecological cancer and ureteral obstruction undergoing periodic ureteral stent replacement were reviewed retrospectively. Ureteral stent removal was attempted in patients who showed improvement in hydronephrosis on abdominal computed tomography (CT) after ureteral stent insertion and who lost symptoms. Success was defined as not having to reinsert the stent because there were no uncomfortable symptoms. The following were evaluated as predictors for ureteral stent removal: pre-removal serum creatinine, hypertension, diabetes, asymptomatic bacteriuria, type of gynecologic malignancy, prior radiotherapy, hydronephrosis laterality, obstruction level, hydronephrosis etiology, ureteral stent size, and ureteral stent duration. The hydronephrosis changes on abdominal CT were also evaluated.
Results: Among 121 patients, 74 with 81 obstructed ureters were evaluated. Of the 81 ureters, successful removal occurred in 30 (37.0%). There were significant differences between the success and failure cases regarding asymptomatic bacteriuria, prior radiotherapy, and hydronephrosis etiology. Logistic regression analysis showed that asymptomatic bacteriuria and hydronephrosis etiology were significant predictors of ureteral stent removal (p<0.05). There were also significant differences in the hydronephrosis changes depending on asymptomatic bacteriuria and hydronephrosis etiology (p<0.05).
Conclusions: In patients with gynecological cancer who have a ureteral stent in place due to ureteral obstruction, ureteral stent removal may be considered in patients who do not have asymptomatic bacteriuria or other etiologies, such as external ureteral pressure or ureteral cancer metastasis.

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Ureteral Stent Induced Urinary Tract Infection and Microbial Inconsistency Between Bladder and Renal Pelvis: Useok Choi, Eun Jae Kim, Don Hee Lyu, Bong Hee Park, Hong Chung, Chang Hee Han, Sangrak Bae; Urogenit Tract Infect 2021;16(3):61-66. Published online December 31, 2021; DOI: https://doi.org/10.14777/uti.2021.16.3.61

Purpose: This study examined the effects of long-term ureteral stent (US) on urinary tract infection (UTI) by bacterial migration and bacterial colonization.
Materials and Methods: From March 2014 to August 2021, 64 patients who underwent US for more than six months were enrolled in this study. When the US was inserted for the first time and replaced regularly, urine was collected from the bladder and renal pelvis and cultured. Patients’ the characteristics, and differences in pathogens related to US infection were analyzed.
Results: The mean age was 66.4 years, and the mean duration of indwelling was 37.5 months. There were 38 cases (59.3%) by malignant and 26 cases (40.6%) by benign causes. UTI occurred in 33 cases (53%); 16 cases (25%) were hospitalized for febrile UTI. After the initial US insertion, bacteria were identified in the bladder 285 days later and in the renal pelvis after 619 days. The bladder culture was positive in 10 of the 33 patients, and renal pelvis alone was positive in nine of the 33 patients. The same strain was confirmed in the bladder and renal pelvis in 12 cases (18.8%), and it took a mean of 5.8 months ± 6.32 (standard deviation) for the upward migration of bacteria.
Conclusions: UTIs occur in approximately 50% of patients with long-term US indwelling. The probability of culturing the same strain by a US was approximately 18.8%, and the role of pathogen transmission of a US does not appear to be significant. In addition, renal pelvis culture would be helpful in cases of failed bladder antibiotics susceptibility.

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Comprehensive analysis of the bacterial spectrum for enhanced clinical insight in microbial ureteral stent colonization, uncomplicated urinary tract infections and catheter-associated urinary tract infections: a principal component analysis-based literatu
Matilde Lepori, Olivier Braissant, Gernot Bonkat, Malte Rieken
World Journal of Urology.2024;[Epub] CrossRef

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