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Infective complications after retrograde intrarenal surgery: a new standardized classification system

  • Urology - Original Paper
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Abstract

Purpose

Retrograde intrarenal surgery (RIRS) is considered a safe procedure; however, infective complications are potentially serious postoperative complications. The aim of this multicentre study was to evaluate prospectively the prevalence of infective complications after RIRS and identify risk factors.

Methods

Baseline data were collected, and patients were questioned regarding postoperative infective complications following RIRS. The Fisher exact test, Student t test, Mann–Whitney U test, and multivariate regression analysis were used for data analysis.

Results

A total of 403 patients from five European centers were included. Antibiotic prophylaxis was administered prior to RIRS in 100 %. Infection complications were recorded in 31 patients (7.7 %), consisting of fever in 18 (4.4 %), SIRS in 7 (1.7), and sepsis in 3 (0.7 %). Three required hospitalization for non-obstructive pyelonephritis (0.7 %). Univariate analysis revealed that coronary heart disease, chronic kidney disease, alteration of lipid metabolism, anticoagulant therapy, past surgery for renal stone, presence of residual fragments were predictors of infective complications. Multivariate analysis did not identify any patient subgroups at a significantly higher risk of infection. The low rate of complications may have limited the conclusions from our study.

Conclusion

Using a standardized method for the definition and classification of infective complication from a multicentre prospective large database, we find a prevalence of 7.7 % of infective complication among patients undergoing RIRS for renal stone. However, to predict which patients will develop infective complications still remains a clinical challenge.

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Authors and Affiliations

  1. Department of Urology, “S. Pio da Pietrelcina” Hospital, Via San Camillo de Lellis, 1, 66054, Vasto, CH, Italy

    Francesco Berardinelli, Piergustavo De Francesco, Michele Marchioni, Luigi Schips & Luca Cindolo

  2. Faculty of Psychology and Educational sciences, University of Porto, Porto, Portugal

    Nicoletta Cera

  3. Ville Turro Division, Urology Department, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy

    Silvia Proietti & Guido Giusti

  4. Department of Urology, Austin Health, Melbourne, Australia

    Derek Hennessey

  5. Urologische Klinik, Medizinische Universität Graz, Graz, Austria

    Orietta Dalpiaz

  6. Urologia, Ospedale Cottolengo, Turin, Italy

    Cecilia Cracco & Cesare Scoffone

Authors
  1. Francesco Berardinelli
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  2. Piergustavo De Francesco
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  3. Michele Marchioni
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  4. Nicoletta Cera
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  5. Silvia Proietti
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  6. Derek Hennessey
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  7. Orietta Dalpiaz
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  8. Cecilia Cracco
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  9. Cesare Scoffone
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  10. Luigi Schips
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  11. Guido Giusti
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  12. Luca Cindolo
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Corresponding author

Correspondence to Francesco Berardinelli.

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Conflict of interest

Guido Giusti is a consultant for Boston Scientific, Cook Medical, Porges-Coloplast, Karl Storz. Cesare Mario Scoffone is a consultant for Boston Scientific, Cook Medical, Porges-Coloplast, Karl Storz. F. Berardinelli, L. Cindolo, P. De Francesco, N. Cera, M. Marchioni, S. Proietti, D. Hennessey, O. Dalpiaz, C. Cracco, and L. Schips have nothing to disclose.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Berardinelli, F., De Francesco, P., Marchioni, M. et al. Infective complications after retrograde intrarenal surgery: a new standardized classification system. Int Urol Nephrol 48, 1757–1762 (2016). https://doi.org/10.1007/s11255-016-1373-1

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  • DOI: https://doi.org/10.1007/s11255-016-1373-1

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