Does Stone Removal Help Patients with Recurrent Urinary Tract Infections?
Mohamed Omar1, Abdullahi Abdulwahab-Ahmed1, Hemant Chaparala1
1Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, Ohio.
The Journal of Urology
|May 5, 2015
Summary
Surgical removal of asymptomatic kidney stones can cure recurrent urinary tract infections in about half of patients. However, factors like hypertension and certain bacterial infections may predict persistent infections post-surgery.
Area of Science:
- Urology
- Infectious Diseases
- Nephrology
Background:
- Recurrent urinary tract infections (UTIs) pose a significant clinical challenge.
- Nonobstructing asymptomatic renal stones are often managed conservatively but may contribute to persistent infections.
Purpose of the Study:
- To evaluate the impact of surgical extraction of nonobstructing asymptomatic renal stones on recurrent UTIs.
- To identify predictors of successful infection eradication after stone removal.
Main Methods:
- Retrospective chart review of 120 patients with recurrent UTIs and asymptomatic renal stones.
- Surgical stone extraction via shock wave lithotripsy, ureteroscopy, or percutaneous nephrolithotomy.
- Statistical analysis including univariate and multivariate logistic regression.
Main Results:
- 48% of patients remained infection-free after stone extraction; 52% experienced recurrent infections.
- Predictors of persistent infection included type 2 diabetes mellitus, hypertension, and black ethnicity.
- Escherichia coli infections were more likely to resolve, while Enterococcus infections were more likely to persist.
Conclusions:
- Approximately 50% of patients with recurrent UTIs and asymptomatic renal calculi may achieve infection-free status post-stone extraction.
- Patients with identified risk factors should be counseled regarding the potential for persistent infection despite surgical intervention.
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