Flexible ureteroscopic lithotripsy is safe and efficient for renal stone <2 cm accompanied with persistent urinary tract infection

J. Da, M. Xu, Yiwei Wang, Jingshen Zhang, Wenfeng Li, Zhong Wang
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Abstract

Background and Objective: The aim is to study the efficacy and safety of flexible ureteroscopic lithotripsy (fURSL) for renal stone with persistent urinary tract infection (UTI). Materials and Methods: We retrospectively included 15 cases of patients diagnosed with renal stone together with persistent UTI, who were treated with fURSL from October 2011 to June 2015. A group of 15 patients diagnosed with renal stone, without any sign of persistent UTI, were set as control group. Standard fURSLs were performed by two experienced urologists. Vital signs, routine blood test and kidney, urine, and bladder were observed as well. The double J stent was removed 2–4 weeks after the operation. Results: All operations were done in one-stage. In UTI group, the average operation time was 30 ± 21 min (15–50 min). The stone-free rate (SFR) was 93.3% (14/15). Two cases (13.3%) of fever were observed after the operation, all happened within 6 h postoperatively, with the highest temperature of 39°C. All patients were cured with antibiotics. Conclusions: It is safe to perform fURSL on renal stone patients with persistent UTI under the protection of sensitive antibiotics. The SFR and postoperative complications were acceptable. Low-pressure irrigation and careful postoperative observation are of great importance for these patients.
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输尿管软镜碎石术对于肾结石<2 cm并持续性尿路感染是安全有效的
背景与目的:探讨柔性输尿管镜碎石术(fURSL)治疗肾结石合并持续性尿路感染(UTI)的疗效和安全性。材料和方法:我们回顾性地纳入了2011年10月至2015年6月期间诊断为肾结石并持续性尿路感染的15例患者。15例诊断为肾结石且无持续性尿路感染征象的患者作为对照组。标准fURSLs由两名经验丰富的泌尿科医生执行。观察生命体征、血常规、肾、尿、膀胱。术后2 ~ 4周取出双J型支架。结果:所有手术均一期完成。UTI组平均手术时间为30±21 min (15 ~ 50 min)。无结石率(SFR)为93.3%(14/15)。术后发热2例(13.3%),均发生在术后6 h内,最高体温39℃。所有患者均用抗生素治愈。结论:在敏感抗生素的保护下,对顽固性尿路感染的肾结石患者行fURSL治疗是安全的。SFR和术后并发症均可接受。对于这些患者,低压冲洗和术后仔细观察是非常重要的。
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