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This Commentary is in response to the BMC Urology publication entitled “Infection-related hospitalization following ureteroscopic stone treatment: Results from a surgical collaborative”. This study utilized a registry with prospectively recorded standardized data elements named Reducing Operative Complications from Kidney Stones, part of the Michigan Urological Surgery Improvement Collaborative, to identify risk factors of infection-related hospitalization after ureteroscopy for stone treatment. The study included 1817 primary URS procedures for urinary stones in 11 practices in Michigan. They found 43 patients (2.4%) were hospitalized with an infection-related complication and 3 patients died during their hospitalization (0.2% mortality rate). Just over 20% of patients did not have a pre-operative urinalysis or urine culture, representing a deviation from guideline recommendations. Also, in the hospitalized group, none of the 12 patients (27.9%) who had a positive pre-operative urinalysis or urine culture received pre-operative treatment. A multivariable analysis identified higher Charleston Comorbidity Index, history of recurrent urinary tract infection, increasing stone size, intraoperative complications, and fragments left in-situ as independent risk factors for hospitalization from an infection after ureteroscopy. This commentary discusses caveats to the data as well as short-comings of the study. It also reviews more broadly infection after ureteroscopy, includes findings from similar studies, and highlights guideline recommendations to reduce infection risk.

bmc urology

Commentary in response to BMC Urology publication entitled “Infection-related hospitalization following ureteroscopic stone treatment: results from a surgical collaborative”