Facteurs favorisants les infections sévères après urétéroscopie souple : intérêt de l’ECBU systématique la veille de l’intervention

Lasselin, Julie; Forzini, T.; Tapsoba, François; Viart, L.; Saint, F.

doi:10.1016/j.purol.2015.09.008

Cited by 15 publications

(5 citation statements)

References 17 publications

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“…However, one point was given to studies that included more than 400 patients, and a second point was given to studies that provided the odds ratios and 95% confidence intervals for independent prognostic factors. Four publications scored 14 or 15 points [ 9 , 13 , 16 , 18 ] and four studies scored 13 points [ 10 , 11 , 14 , 20 ]. However, articles that scored high were not distinctively different from those that scored low in terms of factors analyzed and results.…”

Section: Resultsmentioning

confidence: 99%

“…Most studies analyzed time as a continuous variable, but four used thresholds. Among these, significant relationships were found at thresholds of 70 min [ 10 ], 60 min [ 16 ], and 30 min [ 21 ]; but the relationship was insignificant with a threshold of 120 min [ 7 ]. Most studies found that stone size and preoperative urine culture were significantly related to postoperative infections, although most performed univariate, not multivariate analyses.…”

Section: Resultsmentioning

confidence: 99%

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Risk factors for infectious complications after retrograde intrarenal surgery – a systematic review and narrative synthesis

Dybowski¹,

Bres-Niewada

Rzeszutko³

et al. 2021

Cent european J Urol

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Introduction Infectious complications are among the most frequent and significant complications in retrograde intrarenal lithotripsy. To date, review articles have covered complications after a ureteroscopy, but not after retrograde intrarenal surgery (RIRS), specifically. Because the complications and risk factors are different for a ureteroscopy and RIRS, we aimed to identify variables related to the occurrence of infectious complications post-RIRS. Material and methods This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. We included original studies that described 100 or more procedures published in 2014–2021. We extracted data and performed a narrative synthesis to explore and interpret differences between the studies. Results We selected 17 studies for analysis, including 10 from 2019–2021. Infectious complications after RIRS were observed in 2.8–7.5% of patients (mean 7.1%). We found seven independent risk factors associated with infectious complications after RIRS: long operative time, recent history of positive urine culture or urinary tract infection or antibiotic use, pyuria/nitrites, small caliber of ureteral access sheath, struvite stone, high irrigation rate, and comorbidities. Conclusions If an increased rate of infectious complications is found at a RIRS center, countermeasures should include restrictions on operative time and irrigation rate, and consideration of larger access sheaths, especially for patients with abnormal urine results or with struvite stones or with a history of urinary tract infection or co-morbidities.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Risk factors for infectious complications after retrograde intrarenal surgery – a systematic review and narrative synthesis

Dybowski¹,

Bres-Niewada

Rzeszutko³

et al. 2021

Cent european J Urol

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“…Regarding perioperative complications, UTI remains a feared hurdle following ureteroscopy. A study in France reports that acute pyelonephritis is a rare complication of ureteroscopy (2.4%) (12). In the study by Usawachintachit et al (10), the complication rate was lower in the LithoVue TM group compared to the URF-P6 group (5.4% vs. 18.0%; p <0.05).…”

Section: Resultsmentioning

confidence: 99%

A comprehensive literature-based equation to compare cost-effectiveness of a flexible ureteroscopy program with single-use versus reusable devices

et al. 2019

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Purpose: to critically review all literature concerning the cost-effectiveness of fl exible ureteroscopy comparing single-use with reusable scopes. Materials and Methods: A systematic online literature review was performed in PubMed, Embase and Google Scholar databases. All factors potentially affecting surgical costs or clinical outcomes were considered. Prospective assessments, case control and case series studies were included. Results: 741 studies were found. Of those, 18 were duplicated and 77 were not related to urology procedures. Of the remaining 646 studies, 59 were considered of relevance and selected for further analysis. Stone free and complication rates were similar between single-use and reusable scopes. Operative time was in average 20% shorter with digital scopes, single-use or not. Reusable digital scopes seem to last longer than optic ones, though scope longevity is very variable worldwide. New scopes usually last four times more than refurbished ones and single-use ureterorenoscopes have good resilience throughout long cases. Longer scope longevity is achieved with Cidex and if a dedicated nurse takes care of the sterilization process. The main surgical factors that negatively impact device longevity are lower pole pathologies, large stone burden and non-use of a ureteral access sheath. We have built a comprehensive fi nancial costeffective decision model to fl exible ureteroscope acquisition. Conclusions: The cost-effectiveness of a fl exible ureteroscopy program is dependent of several aspects. We have developed a equation to allow a literature-based and adaptable decision model to every interested stakeholder. Disposable devices are already a reality and will progressively become the standard as manufacturing price falls.

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“…Another discussion point is regarding infection. The occurrence of acute pyelonephritis following ureteroscopy is 2.4%, which is low, but not negligible (21). A study published in 2017 by Ofstead et al, showed the presence of bacteria, hemoglobin and protein inside reusable ureteroscopes after manual cleaning and sterilization by hydrogen peroxide gas but there are no clinical data proving the influence of these findings in the occurrence of post-operative infections following ureteroscopy (22).…”

Section: Potential Advantages Of Single-use Ureteroscopesmentioning

confidence: 98%

Single-use flexible ureteroscopes: update and perspective in developing countries. A narrative review

et al. 2022

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Flexible ureteroscopy is a well-established method for treatment of urinary stones but fl exible ureteroscopes are expensive and fragile devices with a very limited lifetime. Since 2006 with the advent of digital fl exible ureteroscopes a great evolution has occurred. The fi rst single-use fl exible ureteroscope was launched in 2011 and new models are coming to the market. The aim of this article is to review the characteristics of these devices, compare their results with the reusable devices and evaluate the cost-benefi ts of adopting single-use fl exible ureteroscopes in developing countries. Materials and Methods: an extensive review of articles listed at PubMed and published between 2000 and 2021 was performed. Results: Single-use fl exible ureteroscopes have a shaft with 65 to 68cm length and weight between 119 and 277g. Their defl ection goes up to 300 degrees. Their stone-free rates vary between 60 and 95% which is comparable to reusable scopes and operative times ranges from 54 to 86 minutes which are lower when compared to reusable fl exible scopes. Their costs vary between 800 and 3180 US dollars. Conclusion: single-use fl exible ureteroscopes are lighter and have superior quality of image when compared to fi beroptic ones. There are no defi nite data showing a higher stone-free rate or less complications with the use of single-use fl exible ureteroscopes. Each institution must perform a cost-benefi t analysis before making the decision of adopting or not such devices depending on the local circumstances.

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Facteurs favorisants les infections sévères après urétéroscopie souple : intérêt de l’ECBU systématique la veille de l’intervention

Cited by 15 publications

References 17 publications

Risk factors for infectious complications after retrograde intrarenal surgery – a systematic review and narrative synthesis

Risk factors for infectious complications after retrograde intrarenal surgery – a systematic review and narrative synthesis

A comprehensive literature-based equation to compare cost-effectiveness of a flexible ureteroscopy program with single-use versus reusable devices

Single-use flexible ureteroscopes: update and perspective in developing countries. A narrative review

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