Timing of Upper Urinary Tract Stone Surgery After Initial Presentation for Renal Colic With Concomitant Urinary
Wesley R Pate1,2, James W Frisbie1, Charles D Scales3,4,5
1Department of Urology, University of North Carolina, Chapel Hill, North Carolina.
Urology Practice
|December 12, 2025
Summary
Delaying stone surgery for patients with urinary tract infections (UTI) does not reduce 30-day revisits but increases costs. Early surgery is recommended for renal colic patients with UTI to manage costs effectively.
Area of Science:
- Urology
- Health Services Research
Background:
- Renal colic with urinary tract infection (UTI) poses challenges for surgical timing.
- Optimal timing for stone surgery in patients with UTI is not well-defined.
Purpose of the Study:
- To investigate the impact of surgical timing on perioperative outcomes and costs for patients with renal colic and UTI.
- To analyze the association between delayed surgery and 30-day postoperative revisits and episode-related costs.
Main Methods:
- Retrospective analysis of 2018 Healthcare Utilization Project databases.
- Inclusion of 11,695 patients with renal colic, stratified by infection status and time to surgery.
- Statistical analysis using binary logit and ordered logistic regressions to assess outcomes and costs.
Main Results:
- No significant difference in 30-day postoperative revisits based on surgical timing for patients with UTI or sepsis.
- Total episode-related costs were higher with surgery delayed beyond 4 weeks.
- Preoperative costs were significantly higher for delayed surgery compared to surgery within 1 week.
- UTI and sepsis were associated with a higher probability of delayed surgery (>4 weeks).
Conclusions:
- Delaying stone surgery in patients with renal colic and UTI does not improve 30-day postoperative outcomes.
- Delayed surgical intervention increases overall episode-related costs, primarily due to prolonged preoperative periods.
- Urinary tract infection at presentation is a significant factor associated with delays in surgical management.
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