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Article

Post-Ureteroscopy Infections Are Linked to Pre-Operative Stent Dwell Time over Two Months: Outcomes of Three European Endourology Centres

by
Robert M. Geraghty
1,
Amelia Pietropaolo
2,
Luca Villa
3,
John Fitzpatrick
1,
Matthew Shaw
1,
Rajan Veeratterapillay
1,
Alistair Rogers
1,
Eugenio Ventimiglia
3 and
Bhaskar K. Somani
2,*
1
Department of Urology, Freeman Hospital, Freeman Road, Newcastle-upon-Tyne NE7 7DN, UK
2
Department of Urology, University Hospital Southampton, Tremona Road, Southampton SO16 6YD, UK
3
Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2022, 11(2), 310; https://doi.org/10.3390/jcm11020310
Submission received: 5 December 2021 / Revised: 15 December 2021 / Accepted: 7 January 2022 / Published: 9 January 2022
(This article belongs to the Section Nephrology & Urology)
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Abstract

Background: The aim of this study is to investigate outcomes of pre-operative stent dwell time on infectious complications following ureteroscopy and stone treatment to identify a time cut-off. Material and Methods: Three tertiary referral centres in Europe retrospectively collected outcomes of ureteroscopy and laser fragmentation (URSL) for all patients with pre-operative indwelling ureteric stents over a period of up to 5 years. Data was collected on patient details, stone demographics, stent dwell time, complications and stone free rate (SFR). Matching for age, sex, operative time, stone size and post-operative stent insertion. To examine for a threshold effect, monthly cut-offs were used to compare post-ureteroscopic febrile UTIs. Binomial logistic regression was used (SPSS v.24) with a significance level set at 0.0036. The risk ratio (RR) with a 95% confidence interval (CI) and the number needed to harm (NNH) are reported. Results: There were 467 patients with a pre-operative stent for analysis. These patients (n = 315) were matched to non-stented controls after excluding 152 patients to achieve adequate matching. There was a significant difference in rates of post-ureteroscopic febrile UTI between stented vs non-stented patients (RR = 2.67, 95% CI: 1.10–6.48, p = 0.03). On adjustment, a dwell time of more than two months was associated with an increased risk of post-ureteroscopic febrile UTI (RR = 3.94, 95% CI: 1.30–12.01, p = 0.02), this increased risk rose with longer dwell time. At stent time longer than four months was associated with a significantly increased risk of post-ureteroscopic febrile UTI (5% vs. 15%, RR = 3.09, 95% CI: 1.56–6.10, p = 0.001), with the number needed to harm at 10. Conclusions: Overall infectious complication rates from URSL are low. The risk of post-operative UTI after four months of dwell time is nearly tripled compared to less than four months.
Keywords: ureteroscopy; infection; post-operative; ureteric stent; kidney calculi ureteroscopy; infection; post-operative; ureteric stent; kidney calculi

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MDPI and ACS Style

Geraghty, R.M.; Pietropaolo, A.; Villa, L.; Fitzpatrick, J.; Shaw, M.; Veeratterapillay, R.; Rogers, A.; Ventimiglia, E.; Somani, B.K. Post-Ureteroscopy Infections Are Linked to Pre-Operative Stent Dwell Time over Two Months: Outcomes of Three European Endourology Centres. J. Clin. Med. 2022, 11, 310. https://doi.org/10.3390/jcm11020310

AMA Style

Geraghty RM, Pietropaolo A, Villa L, Fitzpatrick J, Shaw M, Veeratterapillay R, Rogers A, Ventimiglia E, Somani BK. Post-Ureteroscopy Infections Are Linked to Pre-Operative Stent Dwell Time over Two Months: Outcomes of Three European Endourology Centres. Journal of Clinical Medicine. 2022; 11(2):310. https://doi.org/10.3390/jcm11020310

Chicago/Turabian Style

Geraghty, Robert M., Amelia Pietropaolo, Luca Villa, John Fitzpatrick, Matthew Shaw, Rajan Veeratterapillay, Alistair Rogers, Eugenio Ventimiglia, and Bhaskar K. Somani. 2022. "Post-Ureteroscopy Infections Are Linked to Pre-Operative Stent Dwell Time over Two Months: Outcomes of Three European Endourology Centres" Journal of Clinical Medicine 11, no. 2: 310. https://doi.org/10.3390/jcm11020310

APA Style

Geraghty, R. M., Pietropaolo, A., Villa, L., Fitzpatrick, J., Shaw, M., Veeratterapillay, R., Rogers, A., Ventimiglia, E., & Somani, B. K. (2022). Post-Ureteroscopy Infections Are Linked to Pre-Operative Stent Dwell Time over Two Months: Outcomes of Three European Endourology Centres. Journal of Clinical Medicine, 11(2), 310. https://doi.org/10.3390/jcm11020310

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