Treatment of non-obstructive, non-struvite urolithiasis is effective in treatment of recurrent urinary tract infections

Deepak K. Agarwal, Amy E. Krambeck, Vidit Sharma, Francisco J. Maldonado, Mary E. Westerman, John J. Knoedler, Marcelino E. Rivera

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Abstract: To determine if treatment of non-obstructing urolithiasis is effective in management of recurrent UTI. Materials and methods: A retrospective review was performed of patients undergoing elective management of non-struvite upper tract urinary calculi with recurrent UTI from 2009 to 2016. Recurrent UTI was defined at ≥ 3 UTI in 12 months, with symptoms and documented urine culture. Preoperative CT was performed in all patients to determine stone burden. All patients had postoperative imaging and ≥ 12 months of follow-up. Pre- and postoperative variables were between patients who had recurrent UTI after treatment versus those who did not. Results: 46 patients met inclusion criteria. 42 (91.3%) were female. Median age was 63.7 years (IQR 49.1, 73.4) and median total stone burden was 20 mm (IQR 14–35). Within the cohort, 20 (43.5%) underwent ureteroscopy only, 26 (56.5%) underwent PCNL ± URS, and none underwent ESWL. Median postoperative follow-up was 2.9 years (IQR 2.0, 4.3). Only five patients (10.9%) had recurrent UTI after treatment. 80% were with the preoperative pathogen. The presence of residual stone was an independent risk factor for recurrent UTI after treatment (p < 0.046). Diabetes, hypertension, immunosuppression and chronic kidney disease were not. Conclusions: Stone removal for patients with recurrent UTIs was associated with a high rate of success (89.1%) in elimination of further recurrent UTIs. Residual fragments are independently associated with persistent recurrent UTIs and thus, complete stone removal is of paramount importance in treatment of this patient population.

Original languageEnglish (US)
JournalWorld Journal of Urology
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Urolithiasis
Urinary Tract Infections
Therapeutics
Ureteroscopy
Urinary Calculi
Chronic Renal Insufficiency
Immunosuppression
Urine
Hypertension

Keywords

  • Endourology
  • Nephrolithiasis
  • Percutaneous nephrolithotomy
  • Ureteroscopy
  • Urinary tract infections

ASJC Scopus subject areas

  • Urology

Cite this

Treatment of non-obstructive, non-struvite urolithiasis is effective in treatment of recurrent urinary tract infections. / Agarwal, Deepak K.; Krambeck, Amy E.; Sharma, Vidit; Maldonado, Francisco J.; Westerman, Mary E.; Knoedler, John J.; Rivera, Marcelino E.

In: World Journal of Urology, 01.01.2019.

Research output: Contribution to journalArticle

Agarwal, Deepak K. ; Krambeck, Amy E. ; Sharma, Vidit ; Maldonado, Francisco J. ; Westerman, Mary E. ; Knoedler, John J. ; Rivera, Marcelino E. / Treatment of non-obstructive, non-struvite urolithiasis is effective in treatment of recurrent urinary tract infections. In: World Journal of Urology. 2019.
@article{cbec199c34ee4f0bb8fd96aa3ee48eba,
title = "Treatment of non-obstructive, non-struvite urolithiasis is effective in treatment of recurrent urinary tract infections",
abstract = "Abstract: To determine if treatment of non-obstructing urolithiasis is effective in management of recurrent UTI. Materials and methods: A retrospective review was performed of patients undergoing elective management of non-struvite upper tract urinary calculi with recurrent UTI from 2009 to 2016. Recurrent UTI was defined at ≥ 3 UTI in 12 months, with symptoms and documented urine culture. Preoperative CT was performed in all patients to determine stone burden. All patients had postoperative imaging and ≥ 12 months of follow-up. Pre- and postoperative variables were between patients who had recurrent UTI after treatment versus those who did not. Results: 46 patients met inclusion criteria. 42 (91.3{\%}) were female. Median age was 63.7 years (IQR 49.1, 73.4) and median total stone burden was 20 mm (IQR 14–35). Within the cohort, 20 (43.5{\%}) underwent ureteroscopy only, 26 (56.5{\%}) underwent PCNL ± URS, and none underwent ESWL. Median postoperative follow-up was 2.9 years (IQR 2.0, 4.3). Only five patients (10.9{\%}) had recurrent UTI after treatment. 80{\%} were with the preoperative pathogen. The presence of residual stone was an independent risk factor for recurrent UTI after treatment (p < 0.046). Diabetes, hypertension, immunosuppression and chronic kidney disease were not. Conclusions: Stone removal for patients with recurrent UTIs was associated with a high rate of success (89.1{\%}) in elimination of further recurrent UTIs. Residual fragments are independently associated with persistent recurrent UTIs and thus, complete stone removal is of paramount importance in treatment of this patient population.",
keywords = "Endourology, Nephrolithiasis, Percutaneous nephrolithotomy, Ureteroscopy, Urinary tract infections",
author = "Agarwal, {Deepak K.} and Krambeck, {Amy E.} and Vidit Sharma and Maldonado, {Francisco J.} and Westerman, {Mary E.} and Knoedler, {John J.} and Rivera, {Marcelino E.}",
year = "2019",
month = "1",
day = "1",
doi = "10.1007/s00345-019-02977-3",
language = "English (US)",
journal = "World Journal of Urology",
issn = "0724-4983",
publisher = "Springer Verlag",

}

TY - JOUR

T1 - Treatment of non-obstructive, non-struvite urolithiasis is effective in treatment of recurrent urinary tract infections

AU - Agarwal, Deepak K.

AU - Krambeck, Amy E.

AU - Sharma, Vidit

AU - Maldonado, Francisco J.

AU - Westerman, Mary E.

AU - Knoedler, John J.

AU - Rivera, Marcelino E.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Abstract: To determine if treatment of non-obstructing urolithiasis is effective in management of recurrent UTI. Materials and methods: A retrospective review was performed of patients undergoing elective management of non-struvite upper tract urinary calculi with recurrent UTI from 2009 to 2016. Recurrent UTI was defined at ≥ 3 UTI in 12 months, with symptoms and documented urine culture. Preoperative CT was performed in all patients to determine stone burden. All patients had postoperative imaging and ≥ 12 months of follow-up. Pre- and postoperative variables were between patients who had recurrent UTI after treatment versus those who did not. Results: 46 patients met inclusion criteria. 42 (91.3%) were female. Median age was 63.7 years (IQR 49.1, 73.4) and median total stone burden was 20 mm (IQR 14–35). Within the cohort, 20 (43.5%) underwent ureteroscopy only, 26 (56.5%) underwent PCNL ± URS, and none underwent ESWL. Median postoperative follow-up was 2.9 years (IQR 2.0, 4.3). Only five patients (10.9%) had recurrent UTI after treatment. 80% were with the preoperative pathogen. The presence of residual stone was an independent risk factor for recurrent UTI after treatment (p < 0.046). Diabetes, hypertension, immunosuppression and chronic kidney disease were not. Conclusions: Stone removal for patients with recurrent UTIs was associated with a high rate of success (89.1%) in elimination of further recurrent UTIs. Residual fragments are independently associated with persistent recurrent UTIs and thus, complete stone removal is of paramount importance in treatment of this patient population.

AB - Abstract: To determine if treatment of non-obstructing urolithiasis is effective in management of recurrent UTI. Materials and methods: A retrospective review was performed of patients undergoing elective management of non-struvite upper tract urinary calculi with recurrent UTI from 2009 to 2016. Recurrent UTI was defined at ≥ 3 UTI in 12 months, with symptoms and documented urine culture. Preoperative CT was performed in all patients to determine stone burden. All patients had postoperative imaging and ≥ 12 months of follow-up. Pre- and postoperative variables were between patients who had recurrent UTI after treatment versus those who did not. Results: 46 patients met inclusion criteria. 42 (91.3%) were female. Median age was 63.7 years (IQR 49.1, 73.4) and median total stone burden was 20 mm (IQR 14–35). Within the cohort, 20 (43.5%) underwent ureteroscopy only, 26 (56.5%) underwent PCNL ± URS, and none underwent ESWL. Median postoperative follow-up was 2.9 years (IQR 2.0, 4.3). Only five patients (10.9%) had recurrent UTI after treatment. 80% were with the preoperative pathogen. The presence of residual stone was an independent risk factor for recurrent UTI after treatment (p < 0.046). Diabetes, hypertension, immunosuppression and chronic kidney disease were not. Conclusions: Stone removal for patients with recurrent UTIs was associated with a high rate of success (89.1%) in elimination of further recurrent UTIs. Residual fragments are independently associated with persistent recurrent UTIs and thus, complete stone removal is of paramount importance in treatment of this patient population.

KW - Endourology

KW - Nephrolithiasis

KW - Percutaneous nephrolithotomy

KW - Ureteroscopy

KW - Urinary tract infections

UR - http://www.scopus.com/inward/record.url?scp=85074043998&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85074043998&partnerID=8YFLogxK

U2 - 10.1007/s00345-019-02977-3

DO - 10.1007/s00345-019-02977-3

M3 - Article

AN - SCOPUS:85074043998

JO - World Journal of Urology

JF - World Journal of Urology

SN - 0724-4983

ER -