Factors for predicting early infection after retrograde intrarenal
surgery (RIRS) in 1-2 cm renal stones
Abstract
Objective: To investigate the factors, especially preoperative
urinalysis, predicting postoperative early infection after retrograde
intrarenal surgery (RIRS) in 1-2 cm renal stones. Methods: Of the 642
patients who underwent RIRS between September 2013 and July 2019, 289
patients with a total stone size of 1-2 cm were included in the study.
Patients were divided into two groups as with and without postoperative
urinary tract infection. The demographic data and perioperative findings
of all patients were retrospectively reviewed. Sterile urine cultures
were obtained in all patients during the preoperative 30-day period and
urine analysis values were included in the data. Results: Urinary system
infection (UTI) was seen in 20 (6.9%) of 289 patients. Patient
demographics were similar between groups. There was no statistically
significant difference between the two groups in terms of stone diameter
and stone localization (median diameter 13.5 vs 15, p=0.285). Patients
with postoperative UTI had a higher rate of UTI history (55% vs 20.5%,
p=0.000) and longer operative times (62.5 vs 60 min., p=0.008). Rate of
pyuria, leukocyte esterase and nitrite positivity were observed more
frequently in patients with postoperative UTI. In multivariate analysis,
UTI history, prolonged operative time, and nitrite positivity were found
to be independent risk factors for postoperative UTI. Conclusion:
Nitrite positivity in preoperative urinanalysis, history of UTI and
prolonged operation time are the factors that predict the postoperative
infection in RIRS for stones between 1-2 cm.