Postoperative infective complications following percutaneous nephrolithotomy

Area of Science:

• Urology
• Nephrology
• Surgical Complications

Background:

• Percutaneous nephrolithotomy (PCNL) is a primary treatment for large renal stones (>2 cm).
• Infective complications, such as fever and urinary tract infections (UTIs), occur in up to one-third of patients post-PCNL.

Purpose of the Study:

• To determine the proportion of patients experiencing post-operative infective complications after PCNL.
• To identify patient, stone, and procedure-related risk factors associated with these complications.

Main Methods:

• An institution-based observational study was conducted over three years (September 2016 - August 2019).
• Data from 190 patients undergoing PCNL were analyzed, including demographic, stone, and procedural factors.
• Infective outcomes evaluated included fever, UTI, pyelonephritis, and sepsis.

Main Results:

• A total of 190 patients were analyzed, with a mean age of 47.7 years; 77.9% were male.
• Post-PCNL infective complications were observed in 18.9% of patients (fever), with 11.1% experiencing UTI, 3.1% pyelonephritis, and 2.6% sepsis.
• The overall incidence of fever and UTI was 18.9% and 11.1%, respectively.

Conclusions:

• Higher rates of post-PCNL infective complications are associated with a history of preoperative UTI.
• Previous renal surgeries, large stone burden, operative times exceeding 90 minutes, and residual calculi are significant risk factors.
• Identifying these risk factors can help in managing and potentially preventing complications.