TAIPEI, TAIWAN (UroToday.com) - Introduction and Objectives: The outcomes of ureteroscopy (URS) after urgent decompression and antibiotics for patients who initially present with urosepsis due to obstructive urolithiasis have not been previously evaluated. The aim of this study was to compare the outcomes and complications of URS in patients with a recent history of sepsis in comparison to those without sepsis.
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Methods: The study included 138 patients who underwent URS for stone removal from January 2004 to September 2011 at a university medical center. A matched-pair analysis was performed using 3 parameters (age, gender and race) to compare outcomes and complications between 69 patients who had sepsis versus a matched cohort who did not have sepsis prior to URS.
Results: The study included 138 patients, 88 females (64%) and 50 males (36%) with median age 57.5 (range, 18–88). Patients with prior sepsis had similar patient characteristics and stone free rates (81% vs 77%) compared to patients without prior sepsis (p > 0.05). However, patients with prior sepsis had a significantly higher complications rate (20% vs 7%), longer length of hospital stay (LOS) and longer courses of postoperative antibiotics after URS (p < 0.05). Two diabetic patients developed sepsis postoperatively (1 with and 1 without prior sepsis) and 5 patients with prior sepsis developed postoperative fever.
Conclusions: URS after decompression for urolithiasis related sepsis has similar success but higher complication rates, greater LOS and longer course of postoperative antibiotics. This is important in counseling patients who present for definitive URS after urgent decompression for urolithiasis related sepsis.
Source of Funding: None
|Listen to an interview with Andreas Neisius, one of the authors of this study.|
Click HERE to listen to one of the authors, Ramy Youssef, MD, discuss this study in a slide presentation.
Presented by Ramy Youssef,1, 3 Andreas Neisius,2 Zachariah Goldsmith,1 Momin Ghaffar,1 Matvey Tsivian,1 Richard Shin,1 Fernando Cabrera,1 Adam Kaplan,1, 3 Michael Ferrandino,1 Charles Scales1,4 Glenn Preminger,1 and Michael Lipkin1 at the 32nd World Congress of Endourology & SWL - September 3 - 7, 2014 - Taipei, Taiwan
1Duke University Medical Center USA
2Universita¨tsmedizin Mainz (Germany)
3University of California, Irvine, CA USA
4Duke Clinical Research Institute USA