E Alezra1, J Lasselin2, T Forzini3, T François2, L Viart4, F Saint5. 1. HERVI EA 3801, service d'urologie-transplantation, université de Picardie Jules-Verne, CHU d'Amiens, avenue R.-Laennec, 80054 Amiens cedex 1, France. Electronic address: eric_alezra@hotmail.fr. 2. HERVI EA 3801, service d'urologie-transplantation, université de Picardie Jules-Verne, CHU d'Amiens, avenue R.-Laennec, 80054 Amiens cedex 1, France. 3. HERVI EA 3801, service d'urologie-transplantation, université de Picardie Jules-Verne, CHU d'Amiens, avenue R.-Laennec, 80054 Amiens cedex 1, France; HeRVI EA 3801, laboratoire de recherche, université de Picardie Jules-Verne, CHU d'Amiens, 80054 Amiens, France. 4. HERVI EA 3801, service d'urologie-transplantation, université de Picardie Jules-Verne, CHU d'Amiens, avenue R.-Laennec, 80054 Amiens cedex 1, France; Laboratoire d'anatomie et d'organogénèse, université de Picardie Jules-Verne, CHU d'Amiens, 80054 Amiens, France. 5. HERVI EA 3801, service d'urologie-transplantation, université de Picardie Jules-Verne, CHU d'Amiens, avenue R.-Laennec, 80054 Amiens cedex 1, France; HeRVI EA 3801, laboratoire de recherche, université de Picardie Jules-Verne, CHU d'Amiens, 80054 Amiens, France; Biobanque de Picardie, université de Picardie Jules-Verne, CHU d'Amiens, 80054 Amiens, France.
Abstract
OBJECTIVES: The objectives of this study have been to determine prognostic factors for acute pyelonephritis (AP) after flexible ureteroscopy (FU), to assess the frequency of readmission for AP and to study the usefulness of urinalysis the day before surgery. METHODS: Between 2010 and 2013, 266 patients have had at least one ureteroscopy (n=325). All infectious complications and unplanned readmissions within the month after FU were retrospectively evaluated. Several data have been collected: age, sex, BMI, surgical indication (calculis or tumor), number of previous ureteroscopies, number of previous surgeries for calculis, stones number, size and location, bilateral interventions, operating time, preoperative ureteral stenting, postoperative stenting, hospitalization stay, urine culture the day before surgery (j-1) and prescription of antibiotic therapy the week before FU. Correlation between these variables and acute pyelonephritis (AP) the month following the USSR was tested (StatView 4.5, SAS Institute) (P<0.05 significant). RESULTS: We observed 24 postoperative APs (7.4%), 17 prior to hospital discharge and 7 requiring rehospitalization. In univariate analysis, the significant prognostic factors of postoperative AP have been: stone size (>14 mm) (P=0.03); operating time (70 minutes) (P<0.005); positive day - 1 urine culture (P<0.001); antibiotics treatment the week before FU (P<0.001). In multivariate analysis, antibiotics prescription during the week before USSR remained significant (P<0.002; RR 5.8 [1.9-15]). CONCLUSION: Acute pyelonephritis requiring unplanned admission after ureteroscopy is a rare complication (2.4%). Urinalysis one day before ureteroscopy could allow early antibiotic therapy and may reduce 63% of unplanned hospital admissions for acute pyelonephritis. LEVEL OF EVIDENCE: 5.
OBJECTIVES: The objectives of this study have been to determine prognostic factors for acute pyelonephritis (AP) after flexible ureteroscopy (FU), to assess the frequency of readmission for AP and to study the usefulness of urinalysis the day before surgery. METHODS: Between 2010 and 2013, 266 patients have had at least one ureteroscopy (n=325). All infectious complications and unplanned readmissions within the month after FU were retrospectively evaluated. Several data have been collected: age, sex, BMI, surgical indication (calculis or tumor), number of previous ureteroscopies, number of previous surgeries for calculis, stones number, size and location, bilateral interventions, operating time, preoperative ureteral stenting, postoperative stenting, hospitalization stay, urine culture the day before surgery (j-1) and prescription of antibiotic therapy the week before FU. Correlation between these variables and acute pyelonephritis (AP) the month following the USSR was tested (StatView 4.5, SAS Institute) (P<0.05 significant). RESULTS: We observed 24 postoperative APs (7.4%), 17 prior to hospital discharge and 7 requiring rehospitalization. In univariate analysis, the significant prognostic factors of postoperative AP have been: stone size (>14 mm) (P=0.03); operating time (70 minutes) (P<0.005); positive day - 1 urine culture (P<0.001); antibiotics treatment the week before FU (P<0.001). In multivariate analysis, antibiotics prescription during the week before USSR remained significant (P<0.002; RR 5.8 [1.9-15]). CONCLUSION:Acute pyelonephritis requiring unplanned admission after ureteroscopy is a rare complication (2.4%). Urinalysis one day before ureteroscopy could allow early antibiotic therapy and may reduce 63% of unplanned hospital admissions for acute pyelonephritis. LEVEL OF EVIDENCE: 5.
Authors: Giovanni S Marchini; Fábio C Torricelli; Carlos A Batagello; Manoj Monga; Fábio C Vicentini; Alexandre Danilovic; Miguel Srougi; William C Nahas; Eduardo Mazzucchi Journal: Int Braz J Urol Date: 2019 Jul-Aug Impact factor: 1.541
Authors: Eduardo Mazzucchi; Giovanni Scala Marchini; Fernanda Christina Gabrigna Berto; John Denstedt; Alexandre Danilovic; Fabio Carvalho Vicentini; Fabio Cesar Miranda Torricelli; Carlos Alfredo Battagello; Miguel Srougi; William Carlos Nahas Journal: Int Braz J Urol Date: 2022 May-Jun Impact factor: 3.050