Iraq: The type of endourologic procedure used for the treatment of kidney stones is not associated with the infectious complication rates, says a new study published in Archives of Italian Urology and Andrology. The risk of infections may be reduced by the prevention of high intrarenal pressure during the procedure.
Endourological treatment is related to a risk of postoperative febrile urinary tract infections and sepsis. Rawa Bapir, Smart Health Tower, Sulaymaniyah, Kurdistan region, Iraq, and colleagues reviewed the reported rate of infectious complications in relation to the type and modality of the endourologic procedure.

The systematic review was conducted according to the PRISMA guidelines. The researchers searched two online databases (PubMed and EMBASE). 49 studies were included out of 243 articles after full-text evaluation.
Based on the study, the researchers reported the following findings:
Random-effects meta-analysis demonstrated that retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL) were associated with not significantly different odds of getting fever (OR = 1.54) or sepsis (OR = 1.52).
The odds of getting fever were not significantly different for mini PCNL compared to standard PCNL (OR = 1.11) and for tubeless PCNL compared to standard PCNL (OR = 1.34).
The odds for fever after PCNL with suctioning sheath were lower than the corresponding odds for standard PCNL (OR = 0.37).
The odds of getting fever after PCNL with perioperative prophylaxis were not different from the corresponding odds after PCNL with perioperative prophylaxis plus a short oral antibiotic course (before or after the procedure) (OR = 1.31).
"The type of endourological procedure used for kidney stone treatment does not appear to be decisive in the onset of infectious complications, although the prevention of high intrarenal pressure during the procedure could be critical in defining infectious complications risk," the authors concluded.
Reference:
Bapir, R., Bhatti, K. H., Eliwa, A., García-Perdomo, H. A., Gherabi, N., Hennessey, D., Mourmouris, P., Ouattara, A., Perletti, G., Philipraj, J., Trinchieri, A., & Buchholz, N. (2022). Infectious complications of endourological treatment of kidney stones: A meta-analysis of randomized clinical trials. Archivio Italiano Di Urologia E Andrologia, 94(1), 97-106. https://doi.org/10.4081/aiua.2022.1.97