Is a history of obstructive pyelonephritis treated without drainage a risk factor for febrile urinary tract infection after ureteroscopic lithotripsy? – a retrospective study from two institutions

Abstract

Abstract Background A history of preoperative obstructive pyelonephritis (OP) is a risk factor for febrile urinary tract infection (fUTI) after ureteroscopic lithotripsy (URSL). However, the impact of a history of OP treatment without drainage on post-URSL fUTI has not yet been studied. Therefore, this study aimed to investigate the impact of a history of OP treatment without drainage on post-URSL fUTI. Methods We retrospectively reviewed the medical records of 229 consecutive patients who underwent URSL at two institutions between September 2019 and August 2023. Risk factors for post-URSL fUTI were analyzed by comparing patient demographics. Additionally, we compared the frequency of post-URSL fUTI among patients with a history of OP treated without drainage, those with a history of OP treated with ureteral stent (US) placement, and those without a history of OP. Results Of the 229 patients, 19 (8.3%) developed post-URSL fUTI. A history of OP was a significant risk factor for post-URSL fUTI. No significant difference in the incidence of post-URSL fUTI was identified between the patients with a history of OP treated without drainage and those treated with US placement (p = 0.6326). The incidence of post-URSL fUTI was significantly higher in patients with OP treated without drainage than in those without a history of OP (p = 0.0493). Conclusions A history of OP was a risk factor for post-URSL fUTI. Additionally, a history of OP treatment without drainage was also a risk factor for post-URSL fUTI.