Introduction & Objectives
\nCurrent EAU guidelines recommend urinary microbiological assessment before stone intervention and treatment of bacteriuria
\nbefore urological procedures breaching the mucosa. Positive pre-operative urine culture has also been associated with infectious
\ncomplications after ureteroscopy, and previous lithotripsy cohorts have identified sex as an independent determinant of culture
\npositivity. This study aimed to identify predictors of positive pre-operative urine culture in patients undergoing endourological surgery
\nfor urolithiasis.
\nMaterials & Methods
\nWe retrospectively analysed consecutive endourological stone procedures performed at a single tertiary centre between September
\n2022 and August 2024. Procedures included ureteroscopy, retrograde intrarenal surgery, percutaneous nephrolithotomy, endoscopic
\ncombined intrarenal surgery and endoscopic bladder stone treatment. Urine cultures were classified as negative, positive,
\ncontaminated or missing. The primary analysis included procedures with negative or positive pre-operative urine culture. Logistic
\nregression was used to assess predictors of culture positivity, including sex, age, procedure type, pre-operative catheter status and
\nurine culture-to-surgery interval. A clustered sensitivity analysis was performed to account for repeated procedures in the same
\npatient.
\nResults
\nA total of 460 procedures in 292 patients were analysed. Overall, urine culture was positive in 121 cases, negative in 266,
\ncontaminated in 33 and missing in 40. The main analysis included 387 procedures with valid positive or negative cultures, yielding a
\npositivity rate of 31.3%. Sex was available in 385\/387 procedures included in this analysis; two procedures with valid cultures could
\nnot be linked to sex data and were excluded from sex-stratified analyses. Among patients with available sex data, positive urine
\nculture was more frequent in females than in males: 88\/204, 43.1%, versus 32\/181, 17.7%; OR 3.53, 95% CI 2.20\u20135.66, p<0.001.
\nOn complete-case multivariable analysis, female sex remained independently associated with positive urine culture: adjusted OR
\n3.54, 95% CI 2.19\u20135.73, p<0.001. Age, RIRS versus non-RIRS procedure, pre-operative catheter status and culture-to-surgery
\ninterval were not independently associated with culture positivity.
\nConclusions
\nPositive pre-operative urine culture was common before endourological stone surgery, occurring in nearly one third of valid cultures.
\nFemale sex was the strongest independent predictor of culture positivity, in line with previous lithotripsy series. These findings
\nreinforce EAU guideline-based systematic urine culture assessment before endourological stone treatment, particularly as positive
\npre-operative culture is a recognised risk marker for post-ureteroscopy infectious complications.<\/p>","protected":false},"excerpt":{"rendered":"
Introduction & Objectives Current EAU guidelines recommend urinary microbiological assessment before stone intervention and treatment of bacteriuria before urological procedures breaching the mucosa. Positive pre-operative urine culture has also been associated with infectious complications after ureteroscopy, and previous lithotripsy cohorts … read more<\/a><\/p>","protected":false},"author":3,"featured_media":251,"menu_order":0,"template":"","meta":{"_acf_changed":false},"portfolio-type":[19],"portfolio-tag":[],"class_list":["post-250","portfolio","type-portfolio","status-publish","has-post-thumbnail","hentry","portfolio-type-unmoderated-posters"],"acf":[],"_links":{"self":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio\/250","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio"}],"about":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/types\/portfolio"}],"author":[{"embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/users\/3"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/media\/251"}],"wp:attachment":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/media?parent=250"}],"wp:term":[{"taxonomy":"portfolio-type","embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio-type?post=250"},{"taxonomy":"portfolio-tag","embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio-tag?post=250"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}