Is negative urine culture necessary for PCNL safety? Experience from a large-volume stone center
ObjectivesTo present our large single-center experience in managing patients with positive urine cultures and kidney stones with total ultrasound-guided percutaneous nephrolithotomy (PNL) and to redefine the role of urine culture in modifying these patients’ treatment plans.Patients and methodsWe re...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-05-01
|
| Series: | Frontiers in Surgery |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2025.1571963/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850122414057324544 |
|---|---|
| author | Xiao Bo Xue Zeng Gang Zhang Chaoyue Ji Song Jin Wenjie Bai Yuzhe Tang Bixiao Wang Jianxing Li |
| author_facet | Xiao Bo Xue Zeng Gang Zhang Chaoyue Ji Song Jin Wenjie Bai Yuzhe Tang Bixiao Wang Jianxing Li |
| author_sort | Xiao Bo |
| collection | DOAJ |
| description | ObjectivesTo present our large single-center experience in managing patients with positive urine cultures and kidney stones with total ultrasound-guided percutaneous nephrolithotomy (PNL) and to redefine the role of urine culture in modifying these patients’ treatment plans.Patients and methodsWe retrospectively reviewed the charts of patients who had undergone PNL in our department from January 2016 to December 2020 and identified 422 eligible patients. These patients were allocated to two groups according to pre-operative urine culture results: negative (Group 1, n = 278) and positive (Group 2, n = 144). All procedures were ultrasound-guided. Standard access was achieved in all patients. Relevant patient characteristics, operative variables, and postoperative data were collected and analyzed, focusing on infection-related data, particularly sepsis.ResultsSuccessful renal access and stone fragmentation were achieved in all patients. At least one standard (24F) tract was established and a negative suction system introduced in every case. Escherichia coli was the most common bacterium in positive urine culture patients. Preoperative serum creatinine differed significantly between Groups 1 and 2 (1.2 ± 0.2 mg/dl vs. 2.0 ± 0.7 mg/dl, p = 0.02). Durations of surgery (79.2 ± 22.2 min) and post-operative hospitalization (7.6 ± 2.1 days) were longer in Group 2 than in Group 1 (58.2 ± 17.2 min) and (5.6 ± 1.1 days), respectively. Group 1 required fewer renal accesses than did Group 2 (1.1 ± 0.2 vs. 1.7 ± 0.2). The immediate stone-free rate was significantly greater in Group 1 (249; 89.2%) than in Group 2 (108; 75%).ConclusionsUltrasound guided PNL with standard access reveals a safe and acceptable results in positive urine culture patients. Preoperative infected urine is not a risk factor for severe septic complications after PNL under controlled conditions. |
| format | Article |
| id | doaj-art-bde413052d9443b4b5eaa4b5222f4bb7 |
| institution | OA Journals |
| issn | 2296-875X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj-art-bde413052d9443b4b5eaa4b5222f4bb72025-08-20T02:34:50ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2025-05-011210.3389/fsurg.2025.15719631571963Is negative urine culture necessary for PCNL safety? Experience from a large-volume stone centerXiao BoXue ZengGang ZhangChaoyue JiSong JinWenjie BaiYuzhe TangBixiao WangJianxing LiObjectivesTo present our large single-center experience in managing patients with positive urine cultures and kidney stones with total ultrasound-guided percutaneous nephrolithotomy (PNL) and to redefine the role of urine culture in modifying these patients’ treatment plans.Patients and methodsWe retrospectively reviewed the charts of patients who had undergone PNL in our department from January 2016 to December 2020 and identified 422 eligible patients. These patients were allocated to two groups according to pre-operative urine culture results: negative (Group 1, n = 278) and positive (Group 2, n = 144). All procedures were ultrasound-guided. Standard access was achieved in all patients. Relevant patient characteristics, operative variables, and postoperative data were collected and analyzed, focusing on infection-related data, particularly sepsis.ResultsSuccessful renal access and stone fragmentation were achieved in all patients. At least one standard (24F) tract was established and a negative suction system introduced in every case. Escherichia coli was the most common bacterium in positive urine culture patients. Preoperative serum creatinine differed significantly between Groups 1 and 2 (1.2 ± 0.2 mg/dl vs. 2.0 ± 0.7 mg/dl, p = 0.02). Durations of surgery (79.2 ± 22.2 min) and post-operative hospitalization (7.6 ± 2.1 days) were longer in Group 2 than in Group 1 (58.2 ± 17.2 min) and (5.6 ± 1.1 days), respectively. Group 1 required fewer renal accesses than did Group 2 (1.1 ± 0.2 vs. 1.7 ± 0.2). The immediate stone-free rate was significantly greater in Group 1 (249; 89.2%) than in Group 2 (108; 75%).ConclusionsUltrasound guided PNL with standard access reveals a safe and acceptable results in positive urine culture patients. Preoperative infected urine is not a risk factor for severe septic complications after PNL under controlled conditions.https://www.frontiersin.org/articles/10.3389/fsurg.2025.1571963/fullPCNLurine culturesafetycomplicationantibiotics |
| spellingShingle | Xiao Bo Xue Zeng Gang Zhang Chaoyue Ji Song Jin Wenjie Bai Yuzhe Tang Bixiao Wang Jianxing Li Is negative urine culture necessary for PCNL safety? Experience from a large-volume stone center Frontiers in Surgery PCNL urine culture safety complication antibiotics |
| title | Is negative urine culture necessary for PCNL safety? Experience from a large-volume stone center |
| title_full | Is negative urine culture necessary for PCNL safety? Experience from a large-volume stone center |
| title_fullStr | Is negative urine culture necessary for PCNL safety? Experience from a large-volume stone center |
| title_full_unstemmed | Is negative urine culture necessary for PCNL safety? Experience from a large-volume stone center |
| title_short | Is negative urine culture necessary for PCNL safety? Experience from a large-volume stone center |
| title_sort | is negative urine culture necessary for pcnl safety experience from a large volume stone center |
| topic | PCNL urine culture safety complication antibiotics |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2025.1571963/full |
| work_keys_str_mv | AT xiaobo isnegativeurineculturenecessaryforpcnlsafetyexperiencefromalargevolumestonecenter AT xuezeng isnegativeurineculturenecessaryforpcnlsafetyexperiencefromalargevolumestonecenter AT gangzhang isnegativeurineculturenecessaryforpcnlsafetyexperiencefromalargevolumestonecenter AT chaoyueji isnegativeurineculturenecessaryforpcnlsafetyexperiencefromalargevolumestonecenter AT songjin isnegativeurineculturenecessaryforpcnlsafetyexperiencefromalargevolumestonecenter AT wenjiebai isnegativeurineculturenecessaryforpcnlsafetyexperiencefromalargevolumestonecenter AT yuzhetang isnegativeurineculturenecessaryforpcnlsafetyexperiencefromalargevolumestonecenter AT bixiaowang isnegativeurineculturenecessaryforpcnlsafetyexperiencefromalargevolumestonecenter AT jianxingli isnegativeurineculturenecessaryforpcnlsafetyexperiencefromalargevolumestonecenter |