Abstract

 
 
 
 Introduction: Flexible ureterorenoscopic laser lithotripsy is the preferred management option for renal stones less than 2 cm. However, flexible ureterorenoscopic laser lithotripsy is not without complications and urinary tract infection is the most common reported complication. Prophylactic antibiotic use, access sheath, low pressure irrigation are few methods to reduce incidence of urinary tract infection. We have studied whether routine use of intravenous furosemide reduces the incidence of febrile urinary tract infection.
 Methods: A total of 70 patients were randomized into two groups where one received intravenous furosemide at the beginning of the procedure and another did not. Flexible ureteroscopic holmium laser lithotripsy was done and patients were followed up for development of febrile urinary tract infection within one week of the procedure.
 Results: 14% of patients who received furosemide and 20% of patients who did not receive developed post- operative febrile urinary tract infection within one week. Two patients in each group had bacteriuria.
 Conclusions: Although the incidence of febrile UTI is lesser with routine use of intravenous furosemide during flexible ureterorensocopic laser lithotripsy, statistical significance could not be proved.
 
 
 
Highlights
Flexible ureterorenoscopic laser lithotripsy is the preferred management option for renal stones less than 2 cm
Conclusions: the incidence of febrile Urinary tract infection (UTI) is lesser with routine use of intravenous furosemide during flexible ureterorensocopic laser lithotripsy, statistical significance could not be proved
Hematuria, renal colic are other common complications associated with the procedure. 3-5,8,9 Furosemide has been reported as an agent that can reduce the reflow of inflammatory substances, and, at the same time, inhibit the absorption of bacteria and toxin, decreasing postoperative infection after endoscopic lithotripsy[12]
Summary
Flexible ureterorenoscopic laser lithotripsy is the preferred management option for renal stones less than 2 cm. Flexible ureterorenoscopic laser lithotripsy is not without complications and urinary tract infection is the most common reported complication. We have studied whether routine use of intravenous furosemide reduces the incidence of febrile urinary tract infection. There have been tremendous developments in the management of renal stones, which have enabled higher clearance rate with minimal invasiveness and complications. In the present urologic practice, flexible ureterorenoscopic laser lithotripsy is the preferred management option for renal stones less than 2 cm. Flexible ureterorenoscopic laser lithotripsy is not without complications, with reported complication rates from 9 to 25 %.37. Urinary tract infection (UTI) is the most common reported complication.
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