Author:
Bapir Rawa,Bhatti Kamran Hassan,Eliwa Ahmed,García-Perdomo Herney Andrés,Gherabi Nazim,Hennessey Derek,Mourmouris Panagiotis,Ouattara Adama,Perletti Gianpaolo,Philipraj Joseph,Trinchieri Alberto,Buchholz Noor
Abstract
Objective: Endourological treatment is associated with a risk of postoperative febrile urinary tract infections and sepsis. The aim of this study was to review the reported rate of infectious complications in relation to the type and modality of the endourologic procedure. Methods: This systematic review was conducted in accordance with the PRISMA guidelines. Two electronic databases (PubMed and EMBASE) were searched. Out of 243 articles retrieved we included 49 studies after full-text evaluation. Results: Random-effects meta-analysis demonstrated that retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL) were associated with not significantly different odds of getting fever (OR = 1.54, 95% CI: 0.99 to 2.39; p = 0.06) or sepsis (OR = 1.52, 95% CI: 0.37 to 6.20, p = 0.56). The odds of getting fever were not significantly different for mini PCNL compared to standard PCNL (OR = 1.11, 95% CI: 0.85 to 1.44; p = 0.45) and for tubeless PCNL compared to standard PCNL (OR = 1.34 95% CI: 0.61 to 2.91, p = 0.47). However, the odds for fever after PCNL with suctioning sheath were lower than the corresponding odds for standard PCNL (OR = 0.37, 95% CI: 0.20 to 0.70, p = 0.002). The odds of getting fever after PCNL with perioperative prophylaxis were not different from the corresponding odds after PCNL with perioperative prophylaxis plus a short oral antibiotic course (before or after the procedure) (OR = 1.31, 95% CI: 0.71 to 2.39, p = 0.38). Conclusions: The type of endourological procedure does not appear to be decisive in the onset of infectious complications, although the prevention of high intrarenal pressure during the procedure could be crucial in defining the risk of infectious complications.
on behalf of U-merge Ltd. (Urology for emerging countries), London-Athens-Dubai
Reference69 articles.
1. Kim DS, Yoo KH, Jeon SH, Lee SH. Risk factors of febrile urinary tract infections following retrograde intrarenal surgery for renal stones. Medicine (Baltimore). 2021; 100:e25182.
2. Fan S, Gong B, Hao Z, et al. Risk factors of infectious complications following flexible ureteroscope with a holmium laser: a retrospective study. Int J Clin Exp Med 2015; 8:11252-9.
3. Zhong W, Leto G, Wang L, et al. Systemic inflammatory response syndrome after flexible ureteroscopic lithotripsy: a study of risk factors. J Endourol 2015; 29:25-8.
4. Berardinelli F, De Francesco P, Marchioni M, et al. Infective complications after retrograde intrarenal surgery: a new standardized classification system. Int Urol Nephrol. 2016; 48:1757-1762.
5. Dybowski B, Bres-Niewada E, Rzeszutko M, et al. Risk factors for infectious complications after retrograde intrarenal surgery - a systematic review and narrative synthesis. Cent European J Urol. 2021;74:437-445.
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