Low Body Mass Index as a Predictive Factor for Postoperative Infectious Complications after Ureterorenoscopic Lithotripsy

Kensaku Seike,Daiki Kato,Tomoki Taniguchi,Koji Iinuma,Takashi Ishida,Keita Nakane,Hiromi Uno,Takuya Koie,Manabu Takai,Hisao Komeda,Masayoshi Tamaki,Shota Fujimoto

doi:10.3390/medicina57101100

Abstract

Background and Objectives: In this study, we aimed to evaluate predictive factors of postoperative fever (POF) after ureterorenoscopic lithotripsy (URSL). Materials and Methods: A total of 594 consecutive patients who underwent URSL for urinary stone disease at Gifu Municipal Hospital and Chuno Kosei Hospital between April 2016 and January 2021 were enrolled in this study. In all patients, antibiotics were routinely administered intraoperatively and the next day after surgery. We used rigid and/or flexible ureterorenoscopes depending on the stone location for URSL. Stones were fragmented using a holmium: YAG laser. The fragments of the stone were manually removed as much as possible using a stone basket catheter. A ureteral stent was placed at the end of the surgery in all cases. Results: The median age and body mass index (BMI) in all patients were 62 years and 23.8 kg/m2, respectively. The median operation duration was 52 min. The most common URSL-related complication was POF in 28 (4.7%) patients. In these patients, the rates of antibiotic administration and ureteral stent insertion before surgery were significantly higher than in those without POF. In multivariate analysis, BMI was associated with POF after URSL. There were no significant differences in predicting POF after surgery in patients who had bacteriuria or received antibiotics before surgery. Conclusions: A low BMI was significantly associated with POF after URS or URSL.

Highlights

Introduction published maps and institutional affilUrinary stones are one of the most common benign urologic diseases, with a lifetime incidence of approximately 10% [1], and a common cause of morbidity and deterioration of quality of life worldwide [2]
The management of urolithiasis has dramatically changed over the last three decades [5]. Invasive techniques such as ureterorenoscopic lithotripsy (URSL), shockwave lithotripsy (SWL), and percutaneous nephrolithotomy (PNL) are the standard treatment modalities based on patient preference, symptoms, stone location, and stone size [6]
We retrospectively reviewed the data of 630 consecutive patients who underwent URSL for urinary stone disease at Gifu Municipal Hospital and Chuno Kosei Hospital between April 2016 and January 2021

Summary

Introduction

Introduction published maps and institutional affilUrinary stones are one of the most common benign urologic diseases, with a lifetime incidence of approximately 10% [1], and a common cause of morbidity and deterioration of quality of life worldwide [2]. In Japan, the incidence of lower urinary tract stones has gradually increased from 4.7/100,000 in 1965 to 9.1/100,000 in 2005 [3]. The estimated age-standardized annual incidence of upper urinary tract stones was 54.2/100,000 in 1965 and 114.3/100,000 in 2005 [4]. The management of urolithiasis has dramatically changed over the last three decades [5]. Invasive techniques such as ureterorenoscopic lithotripsy (URSL), shockwave lithotripsy (SWL), and percutaneous nephrolithotomy (PNL) are the standard treatment modalities based on patient preference, symptoms, stone location, and stone size [6]. URSL has been accepted as the first-line treatment choice for ureter and renal stones, with better stone-free rates than SWL and lower complication rates than PNL [7]

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