Risk Factors Analysis of Urosepsis Following Retrograde Intrarenal Surgery: A Retrospective Study
DOI:
https://doi.org/10.54133/ajms.v8i1.1643Keywords:
Infection, Preoperative preparation, Postoperative care, Retrograde intrarenal surgery, UrosepsisAbstract
Background: Sepsis post retrograde renal surgery (RIRS) is a grave complication. Proper monitoring, antibiotic management, and understanding of risk factors are crucial to reduce sepsis risk and enhance patient outcomes. Objective: To determine risk factors causing postoperative sepsis after RIRS for renal stones. Methods: A retrospective/prospective cohort enrolled 145 patients who underwent RIRS for renal and/or ureteral stones at Ghazi AL-Hariri Hospital for Surgical Specialties. Eligible patient data were collected, including demographic (age, gender), stone parameters (site, side, size), preoperative and postoperative investigations and antibiotic regimen, operative parameters (type of ureteroscope used, prior DJ stent), and postoperative records. Results: Patients aged 19-69 years, predominantly males (60.7%), and 25.5% had diabetes. Stones were predominantly located in the upper pole (36.6%), 44.8% of stones were medium-sized (15-20 mm), and 49.7% were moderate density (800–1200 HU). Post-operatively, 17% of cases developed urosepsis. Multivariate analysis identified diabetes, longer surgery duration, elevated postoperative CRP, and uncontrolled HbA1c as independent risk factors for urosepsis. E. coli was the most common pathogen (44%). The average hospital stay was 2 days, with 49.7% discharged within a single day. The median duration of DJ stenting was 6 weeks. Conclusions: Analysis highlights the multifactorial risk of developing urosepsis post-RIRS, including diabetes, longer procedural time, higher postoperative inflammatory markers, and complex stone characteristics. Comprehensive preoperative planning and meticulous intraoperative techniques will alleviate these risks and help urologists maximize patient outcomes and minimize urosepsis incidence.
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