Üriner sistem taş hastalarında double-j stentlerin kolonizasyonlarında üst uç alt uç farkı var mıdır?


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Keser F., Çakıcı M. Ç. , Yıldırım A. , Atış R. G.

28. Ulusal Üroloji Kongresi, Antalya, Türkiye, 10 - 13 Ekim 2019, ss.9-10

  • Basıldığı Şehir: Antalya
  • Basıldığı Ülke: Türkiye
  • Sayfa Sayıları: ss.9-10

Özet

AIM: To evaluate the double-J stent (DJS) cultures and urinary infection rates of patients treated with urinary stone disease in our clinic and placed with ureteral DJS. MATERIALS-METHODS: Patients who underwent endoscopic ureteral stone surgery for urinary stone disease in our clinic between January 2019 and July 2019 were evaluated retrospectively. Patients with ureteral DJS were included in the study. Preoperative and postoperative urine cultures, stone sizes, type of operation, presence of postoperative residual stones, presence of urinary tract infection within one month postoperatively, duration of DJS and results of seperately sent upper end and lower end cultures of DJS were recorded. DJS placed for other reasons except stone were not included in the study.

RESULTS: Total of 81 patients whose DJS cultures were sent were included in the study. There were 33 male and 48 female patients. The mean age of the patients was 50.2 years. The mean stone size of the patients was 14.6±8,5 mm. While 31% of the patients had primary stone disease, 13% had shock wave lithotripsy (SWL) and 30% had surgical intervention for urinary stone disease before. 26% of the patients had a history of both SWL and surgery. All patients had sterile urine cultures within the last month of surgery. 19 patients (23.5%) had a history of bacteriuria in previous urine cultures. Thirty five patients had hydronephrosis and 37% had urinary catheter (nephrostomy tube or DJS) before the procedure. Total of 33 patients (40.7%) underwent ureteroscopy (URS) for ureteral stones and 48 patients (59.3%) underwent retrograde intrarenal surgery (RIRS) for renal stones. Residual stones were reported in 21% of the patients at postoperative controls. DJSs were removed within an average of 35.9 (12-106) days. 26% of DJSs microorganism was cultured at the upper end and 34% DJSs microorganism was cultured at the lower end. There was no significant difference in terms of gender, age and presence op hydronephrosis by DJS colonization. Gram (+) bacteria colonization was observed more than other microorganisms at both ends of DJSs and E. faecalis was the most common agent. Urinary tract infection within one month postoperatively was developed in four patients (4.9%) and these patients were hospitalized and given antibiotherapy. In 3 (75%) of these patients, the same bacteria that grew in the postoperative urine culture were observed at the upper end and at the lower end of DJSs.

CONCLUSION: DJS colonization was not found to be related with DJS duration time, presence of hydronephrosis, gender and type of operation. DJS have more bacterial growth at the lower ends and the causative agents are usually gram (+) bacteria.