Date of Presentation
5-6-2021 12:00 AM
College
School of Osteopathic Medicine
Poster Abstract
Ureteroscopy with laser lithotripsy is routinely used to remove stones but results in manipulation of the genitourinary mucosa and has a well-established relationship with post-operative sepsis under certain conditions. Postoperative sepsis represents a significant morbidity and mortality cost to patients and the healthcare system. Several studies to determine risk factors for sepsis after ureteroscopy have been completed. Such risk factors include positive preoperative urine cultures, female gender, prolonged preoperative stent time > 1 month, and patients with sepsis at the time of initial stenting. To improve sepsis rates, procedural alterations such as the use of disposable ureteroscopes have been introduced, as there is some evidence that there may be residual bacteria on reusable ureteroscopes after sterilization. It is unclear how much this contributes to postoperative sepsis, as it may be an inflammatory response rather than true bacteremia. Stone type may also be associated with bacteriuria as certain stones, such as struvite (magnesium ammonium phosphate) stones, form only in the presence of urease-producing bacteria such as Proteus, E. coli, and Enterococcus. However, this has been challenged with recent percutaneous nephrolithotomy studies suggesting that struvite stones are created during infections but could potentially be sterilized, while carbonate apatite stones retain imprints of bacteria.
This investigation reviews if there were significant differences over the last three years in mean ureteral stent time, stone composition, or post-operative sepsis rates in patients who underwent ureteroscopy with laser lithotripsy, as well as if the COVID-19 pandemic had any significant impact on this data. Data has been shown that urological procedures has taken drastic decrease in number due to COVID-19 as elective cases were cancelled.
Keywords
kidney calculi, Nephrolithiasis, lithotripsy, sepsis, Bacteriuria, COVID-19
Disciplines
Female Urogenital Diseases and Pregnancy Complications | Male Urogenital Diseases | Medicine and Health Sciences | Nephrology | Urogenital System | Urology
Document Type
Poster
Included in
Female Urogenital Diseases and Pregnancy Complications Commons, Male Urogenital Diseases Commons, Nephrology Commons, Urogenital System Commons, Urology Commons
Retrospective Analysis of Post-Operative Sepsis Rates, Stone Composition, and Ureteral Stent Duration after Ureteroscopy and Laser Lithotripsy During COVID-19
Ureteroscopy with laser lithotripsy is routinely used to remove stones but results in manipulation of the genitourinary mucosa and has a well-established relationship with post-operative sepsis under certain conditions. Postoperative sepsis represents a significant morbidity and mortality cost to patients and the healthcare system. Several studies to determine risk factors for sepsis after ureteroscopy have been completed. Such risk factors include positive preoperative urine cultures, female gender, prolonged preoperative stent time > 1 month, and patients with sepsis at the time of initial stenting. To improve sepsis rates, procedural alterations such as the use of disposable ureteroscopes have been introduced, as there is some evidence that there may be residual bacteria on reusable ureteroscopes after sterilization. It is unclear how much this contributes to postoperative sepsis, as it may be an inflammatory response rather than true bacteremia. Stone type may also be associated with bacteriuria as certain stones, such as struvite (magnesium ammonium phosphate) stones, form only in the presence of urease-producing bacteria such as Proteus, E. coli, and Enterococcus. However, this has been challenged with recent percutaneous nephrolithotomy studies suggesting that struvite stones are created during infections but could potentially be sterilized, while carbonate apatite stones retain imprints of bacteria.
This investigation reviews if there were significant differences over the last three years in mean ureteral stent time, stone composition, or post-operative sepsis rates in patients who underwent ureteroscopy with laser lithotripsy, as well as if the COVID-19 pandemic had any significant impact on this data. Data has been shown that urological procedures has taken drastic decrease in number due to COVID-19 as elective cases were cancelled.