Figure 1. Rate of infectious complications in the study group.
Our study with 400 patients showed a 7.3% rate of postoperative infectious complications, including a 1.5% urosepsis rate (Figure 1). Significant risk factors were preoperative stent type JFil® pigtail suture stent (PSS) on univariate analysis and older age on multivariate logistic regression analysis (OR 1.037; 95% CI 1.006–1.070; p=0.02). No significant difference was found between the different surgeons, operating time, type of ureterorenoscope used (semi-rigid vs. flexible and disposable vs. reusable), used irrigation system, ureteral access sheath use, stone parameters including stone composition, and extraction technique (laser vs. extraction without laser lithotripsy).
The interesting finding of the JFil® PSS as preoperative stent type risk factor for developing infectious complications opens new research opportunities as there are no RCTs or large prospective trials comparing the JFil® PSS with silicone stents or other stent types in terms of infectious complications. Early recognition of infectious complications, including urosepsis, with immediate resuscitation, source control with appropriate drainage of the urinary tract, and culture-based antibiotic therapy is crucial to prevent morbidity, mortality, and hospital readmissions, with special attention to older patients with comorbidities.
Written by: Brecht Devos,1 Vincent De Coninck2,3
- Department of Urology, University Hospitals Leuven, Louvain, Belgium.
- Department of Urology, AZ Klina, Augustijnslei, Brasschaat, Belgium.
- Young Academic Urologists (YAU), Urolithiasis & Endourology Working Party, Arnhem, Netherlands.