MP69-20 ASSOCIATION BETWEEN URETERIC STENT DWELL TIME AND URINARY TRACT INFECTION

Abstract

You have accessJournal of UrologyStone Disease: Surgical Therapy VII (MP69)1 Apr 2020MP69-20 ASSOCIATION BETWEEN URETERIC STENT DWELL TIME AND URINARY TRACT INFECTION Kevin Zhuo*, Nelson Wang, Vaux Kenneth, Enzo Lazzaro, Vass Justin, Kris Rasiah, Michael Wines, Venu Chalasani, and Amanda Chung Kevin Zhuo*Kevin Zhuo* More articles by this author , Nelson WangNelson Wang More articles by this author , Vaux KennethVaux Kenneth More articles by this author , Enzo LazzaroEnzo Lazzaro More articles by this author , Vass JustinVass Justin More articles by this author , Kris RasiahKris Rasiah More articles by this author , Michael WinesMichael Wines More articles by this author , Venu ChalasaniVenu Chalasani More articles by this author , and Amanda ChungAmanda Chung More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000949.020AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Urosepsis following ureteropyeloscopy laser lithotripsy can be associated with significant morbidity and sometimes even death. Urinary foreign bodies can be a risk factor for urinary tract infection (UTI). A number of patients undergoing ureteropyeloscopy laser lithotripsy have ureteric stents in situ. This study aims to investigate possible association between ureteric stent dwell time and the presence of UTI between staged procedures of endoscopic ureteric stone treatment (ureteropyeloscopy). METHODS: A retrospective review of all adult patients who were treated under 7 urologists at a single institution (Royal North Shore Hospital) by ureteropyeloscopy laser lithotripsy or basket removal of upper tract urolithiasis, who already had been presented, was conducted from 01 January 2018 – 30 June 2019. Patient demographic data, pre-operative urine culture results, ureteric stent dwell time, intra-operative complications and post-operative complications were recorded. Data was analysed using IBM SPSS V24. Descriptive analyses were performed. Normally distributed data was analysed using independent t-tests and ANOVA; categorical variables were analysed using Chi-square and Fisher’s exact tests. P-values < 0.05 were considered statistically significant. RESULTS: 172 patients (mean age 56.1 years, range 24.1-93.9) were identified for this study. Of these patients, 23 patients (13.4%) underwent their secondary procedure with a stent dwell time of 1 month or less (Group A); whilst 149 patients (86.6%) underwent ureteropyeloscopy stone treatment with a stent dwell time greater than 1 month (Group B). Overall, 23.3% (40/172) patients booked for ureteropyeloscopy stone treatment had positive pre-operative urine culture results. Among Group A 4.3% patients had positive preoperative urine culture results whereas among Group B 26.2% patients had positive preoperative urine culture results. There was a statistically significant preoperative infection rate between the two groups (p < 0.05). CONCLUSIONS: In conclusion, longer duration of stent dwell time prior to secondary ureteroscopic treatment for upper tract stones is significantly associated with increased rate of positive pre-operative urine culture. Preoperative UTIs are a known risk factor for serious peri-operative complications such as urosepsis and can lead to subsequent morbidity and even mortality. Therefore, patients who have been prestented and are waitlisted for subsequent ureteropyeloscopy laser lithotripsy should be appropriately triaged to schedule their secondary procedure within an appropriate timeframe to help avoid possible serious negative outcomes. Source of Funding: Nil © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1053-e1054 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kevin Zhuo* More articles by this author Nelson Wang More articles by this author Vaux Kenneth More articles by this author Enzo Lazzaro More articles by this author Vass Justin More articles by this author Kris Rasiah More articles by this author Michael Wines More articles by this author Venu Chalasani More articles by this author Amanda Chung More articles by this author Expand All Advertisement PDF downloadLoading ...