Preoperative Bladder Urine Culture as a Predictor of Intraoperative Stone Culture Results: Clinical Implications and Relationship to Stone Composition

Jessica E. Paonessa, Ehud Gnessin, Naeem Bhojani, James C. Williams, James E. Lingeman

Research output: Contribution to journalArticle

19 Scopus citations


Purpose We examine the relationship between urine and stone cultures in a large cohort of patients undergoing percutaneous stone removal and compare the findings in infectious vs metabolic calculi. Materials and Methods A total of 776 patients treated with percutaneous nephrolithotomy who had preoperative urine cultures and intraoperative stone cultures were included in the study. Statistical analysis used chi-square or logistic fit analysis as appropriate. Results Preoperative urine culture was positive in 352 patients (45.4%) and stone cultures were positive in 300 patients (38.7%). There were 75 patients (9.7%) with negative preoperative cultures who had positive stone cultures, and in patients with both cultures positive the organisms differed in 103 (13.3%). Gram-positive organisms predominated in preoperative urine and stone cultures. Conclusions Preoperative urine cultures in patients undergoing percutaneous nephrolithotomy are unreliable as there is a discordance with intraoperative stone cultures in almost a quarter of cases. There has been a notable shift toward gram-positive organisms in this cohort of patients.

Original languageEnglish (US)
Pages (from-to)769-774
Number of pages6
JournalJournal of Urology
Issue number3
StatePublished - Sep 2016



  • kidney calculi
  • nephrolithiasis
  • nephrostomy, percutaneous
  • urinary tract infections

ASJC Scopus subject areas

  • Urology

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