Percutaneous Nephrolithotomy in Patients with Positive Urine Cultures: Do Complications Increase?

Objective: Our aim in this study to determine whether positive urine culture is a risk factor for infectious complications in patients undergoing percutaneous nephrolithotomy (PNL). Materials and Methods: A total of 958 patients, who underwent PNL in our clinic between 2008 and 2015, were included in the study. The patients were divided into two groups with respect to preoperative urine culture results. Group 1 included 126 patients with nonsterile urine culture. As the control group, 130 patients were randomly selected among patients with preoperative negative urine culture and named as group 2. The groups were compared in terms of demographic data, postoperative complications and additional interventions. Results: The mean age was 51.4±1.05 years in group 1 was and 48.7±1.08 years in group 2. On postoperative 1st month computed tomography, postoperative residual stone fragments were observed in 27 patients (21%) in group 1 and 26 patients (20%) in group 2. The groups were similar in terms of treatment success (p=0.878). No significant difference was found between the groups in terms of postoperative fever (p=0.46), sepsis development and intensive care need (p=0.733). Conclusion: PNL would not increase infectious complications in patients with positive urine culture

İdrar Kültürü Pozitif Hastalarda Perkütan Nefrolitotomi: Komplikasyonlarda Artış Var mı?

Amaç: Bu çalışmada amacımız, PNL olan hastalarda pozitif idrar kültürünün enfeksiyöz komplikasyonlar açısından risk faktörü olup olmadığını araştırmaktır. Gereç ve Yöntem: 2008-2015 yılları arasında kliniğimizde PNL olan 958 hasta çalışmaya dahil edildi. Preoperatif idrar kültürü sonuçlarına göre hastalar iki gruba ayrıldı. Kültüründe üreme saptanan 126 hasta grup 1 olarak adlandırıldı. Kontrol grubu olarak 130 hasta idrar kültürü steril hastalar arasından rastgele seçildi. İki grup demografik veriler, postoperatif komplikasyonlar ve ek girişim gerekliliği açısından karşılaştırıldı. Bulgular: Grup 1’deki hastaların yaş ortalaması 51,4±1,05, grup 2’deki hastaların yaş ortalaması ise 48,7±1,08 yıldı. Postoperatif 1. ayda istenen bilgisayarlı tomografide grup 1’de 27 hastada (%21), grup 2’de ise 26 hastada (%20) rezidü taş saptandı. Operasyon başarısı açısından iki grup benzerdi (p=0,878). Yine gruplar arasında Postoperatif ateş (p=0,46), sepsis gelişimi ve yoğun bakım ihtiyacı açısından fark izlenmedi (p=0,46). Sonuç: Pozitif idrar kültürü olup da antibiyotik alırken yapılan PNL enfeksiyöz komplikasyonları artırmamaktadır.

Kaynakça

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Gutierrez J, Smith A, Geavlete P, Shah H, Kural AR, de Sio M, Amón Sesmero JH, Hoznek A, de la Rosette J; CROES PCNL Study Group. Urinary tract infections and post-operative fever in percutaneous nephrolithotomy. World J Urol 2013;31:1135-1140.

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