Role of Ureteroscopy (URS) and Stone Treatment in Patients with Recurrent UTIs: Outcomes over a 10-Year Period

Abstract

Background. The study aimed to assess whether the eradication of kidney stones might result in a substantial reduction in the onset of recurrent UTIs. Methods. We selected all the patients who underwent ureteroscopy (URS) for stone disease between 2012 and 2021, with either a history of recurrent UTIs (rUTIs), urosepsis or pre-operative positive urine culture (UC). Data included patient demographics, microbiological data, stone parameters, stone-free and infection-free rates (SFR and IFR, respectively) at follow-up, defined as fragments <2 mm at imaging and the absence of symptoms and urine-culture-proven UTI. Results. Overall, 178 patients were selected. The median age was 62 years. The median cumulative stone size was 10 mm (7–17.25), and the commonest locations were the lower pole (18.9%) and proximal ureter (14.9%). The overall stone-free rate at follow-up was 89.3%. The IFR at 3 months was 88.3%. As follow-up duration increased, the IFR reduced to 85.4%, 74.2%, 68% and 65% at 6, 12, 18 and 24 months, respectively. Patients who had infection recurrence were more likely to present stone persistence or recurrence compared to those who were infection-free at follow-up (20% vs. 4.4%, p = 0.005). Conclusions. SFR after URS is a significant predicting variable for the likelihood of infection-free status at follow-up in patients with an rUTI or positive UC at the time of URS.

Is ureteroscopy and active stone treatment safe and effective in octogenarians? A review of current literature

“…As most of the postoperative complication seen in the studies included in our review might be reported to pre-existing medical conditions, an accurate pre-assessment is mandatory to plan an active intervention. When the overall general health of the elderly patients makes the procedure feasible, and the life expectancy is long enough, it has been shown that an active stone treatment can affect positively the quality of life, also reducing the risks of recurrent infections and sepsis related to an untreated urolithiasis [ 23–25 ].…”

Urinary Tract Infections: Prevention, Diagnosis, and Treatment

“…The original paper by Ripa et al analyzed data of 178 consecutive patients with recurrent UTIs, sepsis, or pyelonephritis who underwent ureteroscopy and laser lithotripsy (FURSL) as a treatment for their urinary stones over a 10-year period. The study showed that 88.8% of the patients were infection-free after the treatment [14]. The overall rate of early post-operative UTI recurrences was 6.2%, with a gradual increase over time, mostly related to stone recurrence.…”