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Risk factors of early infectious complications after ureterorenoscopy for stone disease: a prospective study

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World Journal of Urology Aims and scope Submit manuscript

A Letter to the Editor to this article was published on 03 June 2024

Abstract

Purpose

To prospectively evaluate the rate and associated risk factors of early infectious complications after ureterorenoscopy for urolithiasis.

Methods

After ethical committee approval, 400 therapeutic retrograde ureterorenoscopy procedures between August 3, 2020 and November 24, 2021 were included for analysis in a single-center study. Postoperative infection was defined as an afebrile urinary tract infection, fever (≥ 38 °C) with pyuria (≥ 300 WBC/μL) or proven urinary pathogen, and urosepsis. The primary outcome was the rate of infectious complications after ureterorenoscopy. Secondary outcomes were the perioperative factors that increased the risk of infectious complications within 30 days of surgery using univariate and multivariate logistic regression analysis.

Results

Twenty-nine of four hundred (7.3%) patients developed an infectious complication within 30 days after ureterorenoscopy. Ten (2.5%) patients developed an afebrile urinary tract infection, eight (2.0%) developed fever with pyuria, five (1.3%) febrile urinary tract infection, and six (1.5%) urosepsis. On univariate analysis, preoperative stent-type JFil® pigtail suture stent was significantly associated with the dependent variable (p < 0.001). On multivariate logistic regression analysis, older age (OR 1.035; 95% CI 1.006–1.070; p = 0.02) was found to be significantly associated with developing a postoperative infectious complication.

Conclusions

A 7.3% rate of postoperative infectious complications and 1.5% urosepsis rate were observed after therapeutic ureterorenoscopy, without the need of intensive care admission. The only significant risk factors were preoperative stent type (JFil® pigtail suture stent) on univariate analysis, and older age on multivariate logistic regression analysis. Further multicentric prospective observational data are needed in this field.

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Data availability

The data that support the findings of this study are available on request from the corresponding author.

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Acknowledgements

We owe a significant debt of gratitude to Martial Luyts, an esteemed biostatistics expert from the University of Leuven, for his invaluable statistical assistance in crafting this paper.

Disclosures

Vincent De Coninck is a speaker and/or consultant for BD, Coloplast, and Karl Storz, and has no specific conflicts relevant to this study. Etienne Xavier Keller is a speaker and/or consultant for Coloplast, Olympus, Boston Scientific, Recordati, Debiopharm and Alnylam, and has no specific conflicts of interest relevant to this work. All other authors have no relevant financial or non-financial interests to disclose.

Funding

No funding was received for conducting this study.

Author information

Authors and Affiliations

  1. Faculty of Medicine, University Hospitals Leuven, Louvain, Belgium

    Brecht Devos, Wies Vanderbruggen & Ben Van Cleynenbreugel

  2. Department of Urology, AZ Klina, Augustijnslei 100, 2930, Brasschaat, Belgium

    Marc Claessens, Aline Duchateau, Robert Hente & Vincent De Coninck

  3. Young Academic Urologists (YAU), Urolithiasis & Endourology Working Party, 6846, Arnhem, Netherlands

    Etienne Xavier Keller, Amelia Pietropaolo & Vincent De Coninck

  4. Department of Urology, University Hospital Zurich, University of Zurich, Zurich, Switzerland

    Etienne Xavier Keller

  5. Department of Urology, University Hospital Southampton, Southampton, UK

    Amelia Pietropaolo

  6. Department of Development and Regeneration, KU Leuven, Louvain, Belgium

    Ben Van Cleynenbreugel

Authors
  1. Brecht Devos
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  2. Wies Vanderbruggen
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  3. Marc Claessens
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  4. Aline Duchateau
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  5. Robert Hente
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  6. Etienne Xavier Keller
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  7. Amelia Pietropaolo
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  8. Ben Van Cleynenbreugel
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  9. Vincent De Coninck
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Contributions

B Devos: project development, data collection or management, data analysis, manuscript writing. M Claessens: project development, data collection or management. A Duchateau: project development, data collection or management. R Hente: project development, data collection or management. W Vanderbruggen: project development, data collection or management. E.X. Keller: manuscript editing. A. Pietropaolo: manuscript editing. B Van Cleynenbreugel: project development, data analysis, manuscript editing. V De Coninck: research concept, protocol/project development, data collection or management, data analysis, manuscript writing/editing.

Corresponding author

Correspondence to Vincent De Coninck.

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This is a prospective study. Patients were consented for their participation.

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Devos, B., Vanderbruggen, W., Claessens, M. et al. Risk factors of early infectious complications after ureterorenoscopy for stone disease: a prospective study. World J Urol 42, 277 (2024). https://doi.org/10.1007/s00345-024-04983-6

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