2018 Volume 31 Issue 2 Pages 212-217
Objectives : We investigated whether a shortened stent placement duration before ureteroscopic lithotripsy with a holmium laser (URSL) contributed to a reduction in postoperative febrile urinary tract infection (post-UTI).
Methods : We performed a study of 109 patients who underwent URSL. All patients underwent indwelling ureter stent placement before URSL (pre-stent) for various reasons. In half of the patients (Group B, n = 55), the pre-stent duration was shortened as much as possible, whereas in the other half (Group A, n = 54), URSL was performed without the pre-stent duration being shortened. We compared post-UTI incidence in the two groups.
Results : The pre-stent duration was significantly shorter in Group B than in Group A (16.9 vs. 34.4 days), and the post-UTI incidence was significantly reduced in Group B compared to Group A (5.5% vs. 20.4%). In Group A, the incidence of post-UTI was high among patients who underwent pre-stenting for obstructive pyelonephritis (35.0%). Compared to the patients who the duration of pre-stent was less than 28 days, the incidence of post-UTI was significantly higher in the patients who the duration was more than 29 days (8.3% vs. 28.0%). Female patients and patients in Group A were independently more likely to develop post-UTI.
Conclusions : Our findings suggest that patients who undergo pre-stenting are at a high risk of developing post-UTI after URSL, especially those with obstructive pyelonephritis. Because of higher incidence of post-UTI among patients who the pre-stent duration was more than 29 days, the duration should be shortened as much as possible to reduce the occurrence of post-UTI.
