1063 PREDICTIVE FACTOR FOR FEBRILE URINARY TRACT INFECTION AFTER URETEROSCOPIC PROCEDURES

Abstract

You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Kidney & Bladder (I)1 Apr 20131063 PREDICTIVE FACTOR FOR FEBRILE URINARY TRACT INFECTION AFTER URETEROSCOPIC PROCEDURES Masafumi Kita, Masaki Watanabe, Kazumi Hashizume, Tatsuya Iwata, Seiji Matsumoto, and Hidehiro Kakizaki Masafumi KitaMasafumi Kita Asahikawa, Japan More articles by this author , Masaki WatanabeMasaki Watanabe Asahikawa, Japan More articles by this author , Kazumi HashizumeKazumi Hashizume Asahikawa, Japan More articles by this author , Tatsuya IwataTatsuya Iwata Asahikawa, Japan More articles by this author , Seiji MatsumotoSeiji Matsumoto Asahikawa, Japan More articles by this author , and Hidehiro KakizakiHidehiro Kakizaki Asahikawa, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.649AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Febrile urinary tract infection (f-UTI) is a major complication associated with ureteroscopic procedures and, in some cases, leads to a life-threatening event. However there have been few reports investigating factors influencing the prevalence of f-UTI after diagnostic and therapeutic ureteroscopy. The aim of this study is to clarify predictive valuables of f-UTI related to ureteroscopic procedures. METHODS A retrospective review of the medical records of 215 consecutive patients undergoing ureteroscopic procedures was performed. These cases were divided into two groups: transurethral lithotripsy (TUL) group (112 cases, 66 males and 46 females, mean age 63.2±1.3 years) and ureteroscopic investigation (USI) group (103 cases, 56 males and 47 females, mean age 69.1±1.3 years). Risk factors for f-UTI were evaluated using univariate and multivariate analysis. RESULTS Mean operating time was 81.8±3.9 min in TUL group and 26.5±1.6 min in USI group. Prevalence of f-UTI was 11.6% in TUL group and 13.6% in USI group. Univariate analysis revealed that the presence of preoperative bacteriuria (p<0.001), renal stone (p=0.013), use of access sheath during lithotripsy (p=0.025), history of f-UTI (p=0.032) and operating time (p=0.008) had a significant relationship with f-UTI in TUL group. Multivariate logistic regression analysis revealed that operating time and preoperative bacteriuria were risk factors for f-UTI after TUL (Table1). In USI group, there was no single factor that had a significant relationship with f-UTI. However, among cases of USI group, those with both positive preoperative bacteriuria and persistent hydronephrosis after ureteroscopy had more than 2.5 times larger risk for f-UTI compared with other cases. CONCLUSIONS The reason why there were no significant risk factors for f-UTI in USI group might be explained by considerably short operating time compared to TUL group. When TUL is to be performed, reducing operating time is an important factor to prevent postoperative f-UTI especially in those cases with positive bacteriuria and renal stone. Table 1. univariate and multivariate analysis of factors elicitting f-UTI after transurethral lithotripsy univariate analysis univariate analysis multivariate analysis multivariate analysis OR P value OR P value age 1.03 .192 - - sex 0.56 .324 - - size of calculi 1.05 .141 - - preoperative ESWL 0.35 .328 - - preoperative bacteriuria 14.10 .001 16.70 .001 history of f-UTI 4.73 .012 - - ranal stone 0.22 .02 - - diabetes mellitus 0.43 .436 - - access seath 3.65 .032 - - perforation 0.67 .71 - - postoperative ureteral stenting 1.14 .872 - - operating time 1.02 .012 1.02 .018 ESWL: Extracorporeal shock wave lithotripsy, OR: odds ratio © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e436 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Masafumi Kita Asahikawa, Japan More articles by this author Masaki Watanabe Asahikawa, Japan More articles by this author Kazumi Hashizume Asahikawa, Japan More articles by this author Tatsuya Iwata Asahikawa, Japan More articles by this author Seiji Matsumoto Asahikawa, Japan More articles by this author Hidehiro Kakizaki Asahikawa, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...