You have accessJournal of UrologyStone Disease: Surgical Therapy III1 Apr 2016MP33-01 RISK FACTORS FOR FEBRILE URINARY TRACT INFECTION AFTER URETEROSCOPIC STONE REMOVAL Yuji Kato, Tatsuro Koseki, Ryo Mastsutani, Takumi Sasao, Hideki Wada, Kiyohito Yamazaki, and Taketoshi Saka Yuji KatoYuji Kato More articles by this author , Tatsuro KosekiTatsuro Koseki More articles by this author , Ryo MastsutaniRyo Mastsutani More articles by this author , Takumi SasaoTakumi Sasao More articles by this author , Hideki WadaHideki Wada More articles by this author , Kiyohito YamazakiKiyohito Yamazaki More articles by this author , and Taketoshi SakaTaketoshi Saka More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1358AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We investigated the risk factors for febrile urinary tract infection (f-UTI) after ureteroscopic lithotripsy with a holmium laser (URSL). METHODS This retrospective study included 321 patients (218 men and 103 women) who underwent URSL between April 2014 and March 2015 at our hospital. Flexible and rigid URSL were performed in 267 and 54 patients, respectively. Postoperative f-UTI (post-UTI) was defined as fever with a temperature over 37.5°C for 2 days and acute pyelonephritis after removal of the ureteral stent. We compared the patients with post-UTI to those without post-UTI, and we assessed the risk factors for post-UTI using logistic regression analysis. RESULTS he total stone-free rate was 90.8%, and the median operation time was 45.6 minutes. Preoperative obstructive pyelonephritis due to a ureteral stone was noted in 22 patients. Before URSL, a ureteral stent was used in 47 patients and percutaneous nephrostomy was performed in 11 patients. The incidence of post-UTI was 8.1% (26 patients). Post-UTI developed in 6 patients immediately after the operation and in 10 patients after removal of the ureteral stent. The incidence of sepsis was 1.6%. The proportion of female patients was significantly higher among patients with post-UTI than among those without post-UTI (76.9% vs. 5.1%). The rates of preoperative obstructive pyelonephritis (26.9% vs. 5.1%), preoperative ureteral stent insertion (32.0% vs. 13.7%), and infectious stones composed of magnesium ammonium phosphate (33.3% vs. 6.4%) were significantly higher among patients with post-UTI than among those without post-UTI. Moreover, the median operation time was significantly longer (56.2 vs. 44.7 minutes) and the mean age was higher (62.7 vs. 56.9 years) among patients with post-UTI than among those without post-UTI. In univariate logistic regression analysis, age, female sex, operation time, history of preoperative f-UTI, preoperative ureteral stent placement, and presence of infectious stones were significant risk factor for post-UTI. Multivariate logistic regression analysis indicated that female sex, history of preoperative f-UTI, and presence of infectious stones were independent risk factors for post-UTI. CONCLUSIONS Female sex, history of preoperative f-UTI, and presence of infectious stones are risk factors for f-UTI following URSL. Hence, preoperative UTI should be carefully treated with proper antibiotics and urine drainage to avoid aggravation of the infection after URSL, particularly in female patients. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e436 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Yuji Kato More articles by this author Tatsuro Koseki More articles by this author Ryo Mastsutani More articles by this author Takumi Sasao More articles by this author Hideki Wada More articles by this author Kiyohito Yamazaki More articles by this author Taketoshi Saka More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...