Stenting, Surgery Time Linked to Infection After Laser Lithotripsy

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3.4% of patients had an unplanned hospital return for genitourinary infection, with most requiring inpatient readmission.
3.4% of patients had an unplanned hospital return for genitourinary infection, with most requiring inpatient readmission.

(HealthDay News) -- Preoperative stenting and longer operative time are associated with a greater likelihood of serious genitourinary infection after ureteroscopy with laser lithotripsy, according to a study published in The Journal of Urology.

In an effort to identify factors leading to unplanned hospital returns, Rachel A. Moses, MD, from the Dartmouth Hitchcock Medical Center in Lebanon, NH, and colleagues retrospectively reviewed charts for all 550 patients undergoing ureteroscopy with laser lithotripsy which were performed at a single academic institution from April 2011 to August 2014.

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The researchers found that, overall, 3.4% of patients had an unplanned return for genitourinary infection, with most (15 of 19) requiring inpatient readmission. Compliance with American Urological Association (AUA) Best Practice Statement for antibiotic prophylaxis was 48.7% (268 of 550). Patients undergoing preoperative stenting (P = 0.025), those with an operative time greater than 120 minutes (P < 0.001), and those for whom there was AUA Best Practice Statement compliance for antibiotic prophylaxis (P = 0.007) had higher rates of infection-related hospital returns.

"Interestingly the AUA Best Practice Statement compliance for antibiotic prophylaxis was also associated with a higher risk of infection, underscoring the need for locally appropriate prophylaxis strategies and further study of optimal prophylaxis regimens," the authors write.

Sources

  1. Moses RA, Ghali FM, Pais Jr. VM, Hyams ES, et al. Unplanned Hospital Return for Infection following Ureteroscopy—Can We Identify Modifiable Risk Factors? J Urol. doi: 10.1016/j.juro.2015.09.074.
  2. Pearle MS. Is Ureteroscopy as Good as We Think? J Urol. doi: 10.1016/j.juro.2016.01.061.
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