Related Experiment Video
Updated: Sep 4, 2025

Establishment and Characterization of UTI and CAUTI in a Mouse Model
Published on: June 23, 2015
Ureteral Stent Colonization and Urinary Tract Infection in Children Undergoing Minimally Invasive Pyeloplasty
Amos Neheman1,2, Itay M Sabler1, Ilia Beberashvili3
1Department of Urology, Shamir Medical Center, Zerifin, Israel.
Insights
Urinary tract infections (UTIs) are common after minimally invasive pyeloplasty (MIP) in children. Bacteria cultured from stents and urine are usually unrelated, suggesting routine stent culturing has low clinical value.
Area of Science:
- Pediatric Urology
- Infectious Diseases
- Surgical Outcomes
Background:
- Minimally invasive pyeloplasty (MIP) is increasingly used in children.
- Indwelling Double-J ureteral stents are common after MIP.
- Urinary tract infections (UTIs) are a known complication associated with foreign bodies like stents.
Purpose of the Study:
- To identify bacteria causing UTIs in children undergoing MIP with indwelling ureteral stents.
- To determine the relationship between bacteria cultured from urine and stents.
- To assess the clinical significance of routine stent culturing.
Main Methods:
- Retrospective review of 30 children (2.7 years median age) who underwent MIP (2014-2017).
- Urine and stent cultures were obtained at various time points.
- Patient demographics, stent types, and surgical details were recorded.
Main Results:
- 13% of patients developed febrile UTI, and 13% developed afebrile UTI.
- Stent cultures were positive in 63% of patients, but rarely matched urine cultures.
- No association found between UTI and gender, stent diameter, or indwelling duration.
Conclusions:
- UTIs occur in about a quarter of children post-MIP.
- Post-surgical urinary pathogens are typically unrelated to stent colonizers.
- Routine stent culturing offers low clinical significance; optimizing pre-operative antibiotic therapy may be beneficial.
Introduction:
Minimally invasive pyeloplasty (MIP), namely, laparoscopic and robot-assisted interventions, has gained popularity in recent years. Double-J ureteral stents are frequently inserted during surgery. Foreign bodies in the urinary tract are considered as risk factor for developing urinary tract infection (UTI). This study aimed to specify the bacteria cultured from urine and stents responsible for UTI in children with indwelling ureteral stents undergoing MIP.
Patients And Methods:
We retrospectively reviewed medical records of 30 children (22 boys and 8 girls) who had undergone MIP between 2014 and 2017. Median age at surgery was 2.7 years (interquartile range [IQR]: 0.5-7.9). Urine cultures were obtained before surgery, before stent removal, 1 month after stent removal, and if UTI was suspected. Stents were removed 4 to 8 weeks after surgery and cultured. Patients' demographics, types of stents, and surgical details were recorded.
Results:
Median stent indwelling time was 5.09 weeks (IQR: 4-6). Postoperative febrile UTI developed in 4/30 (13%) patients. Afebrile UTI occurred in another 4/30 (13%) patients. Stent cultures were positive in 19/30 (63%) patients. Stent and urinary cultures were identical in only one patient. Three of four patients with preoperative asymptomatic bacteriuria developed postoperative UTI. There was no association between UTI, gender, stent diameter, and duration of indwelling catheter.
Conclusion:
After MIP, febrile UTI and afebrile UTI occurred in about one quarter of patients. Pathogens isolated postsurgically from urinary cultures were unrelated to those colonizing the stents. Therefore, routine stent culturing is of low clinical significance. Moreover, small-caliber stents and longer indwelling periods were not risk factors for UTI. Optimizing antibiotic treatment for children with preoperative UTI may potentially prevent morbidity after surgery.
Related Concept Videos
Acute Pyelonephritis I: Introduction
Urinary Tract Infection II: Pathophysiology
Kidney Transplant II: Surgical Procedure
Acute Pyelonephritis II: Diagnostic Studies and Management
Urinary Tract Infection I: Introduction
Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care

