Category: Clinical Stones: Ureteroscopy

MP29-13 - Stone bacterial culture is necessary at transurethral lithotripsy in case that has history of urinary tract infection

Sun, Sep 23
2:00 PM - 4:00 PM

Introduction & Objective :

It is important to prevent postoperative complications of transurethral lithotripsy (TUL), especially postoperative acute pyelonephritis, sepsis and disseminated intravascular coagulation (DIC). Even if preoperative urine culture is negative, some cases complicate postoperative high fever. These are likely to be caused by bacteria present in the stones. We investigated the importance of stone culture, and that which cases require stone culture.


Methods :

87 patients with ureteral or kidney stone examined preoperative urine culture and underwent transurethral lithotripsy. Bacterial stone culture samples were obtained by this method: 5ml saline was added to stone and stone was pulverized with forceps<./p>


Results :

Of the 87 patients, 15 patients underwent TUL after treatment of obstructive pyelonephritis and 5 patients had postoperative acute pyelonephritis. The positive rate of preoperative urine culture and stone culture was 25.3% (22/87) and 19.5% (17/87). Especially in case after treatment of obstructive pyelonephritis, the positive rate of stone culture was 73.3% (11/15). The concordance rate between preoperative urine culture and stone culture was 87.4% (76/87). On the other hand, all cases in which preoperative urine culture was negative and there was no history of urinary tract infection were negative stone culture, and had not postoperative pyelonephritis.


Conclusions :

In case that has no history of urinary tract infection, and preoperative urine culture is negative, stone bacterial culture is not necessary. On the other hand, in case that has history of urinary tract infection especially obstructive pyelonephritis, and preoperative urine culture is positive, stone bacterial culture is necessary and effective, and we have to select appropriate antibiotics with reference to preoperative urinary culture and stone culture.

Genya Nishikawa

Assistant
Aichi Medical University School of Medicine
Nagakute, Aichi, Japan

Kogenta Nakamura

Nagakute, Aichi, Japan

Ikuo Kobayashi

Nagakute, Aichi, Japan

Miho Sugie

Nagakute, Aichi, Japan

Hiroyuki Muramatsu

Nagakute, Aichi, Japan

Shingo Morinaga

Nagakute, Aichi, Japan

Keishi Kajikawa

Nagakute, Aichi, Japan

Masahito Watanabe

Nagakute, Aichi, Japan

Kenji Zennami

Nagakute, Aichi, Japan

Kent Kanao

Nagakute, Aichi, Japan

Makoto Sumitomo

Nagakute, Aichi, Japan