28. Ulusal Üroloji Kongresi, Antalya, Turkey, 10 - 13 October 2019, pp.7-8
BACKGROUND: Flexible ureteroscopy (f-URS) is used as the gold standard surgical method especially in urinary stones less than 2 cm. This operation, which concerns a large population of patients, results in prolongation of operation waiting periods in high-volume centers. The aim of
the study is to assess the effect of awaiting period (Δ-day) prior to flexible ureteroscopy for postoperative urinary tract infections (UTI) in our tertiary referral institution.
METHODS: After the local ethics committee approval, a retrospective audit was conducted for all flexible ureteroscopy procedures between January 2017 and March 2019. Procedure-related information and perioperative data were collected on the elective waiting lists for each month. The group with postoperative UTI was compared with the control group.
RESULTS: A total of 916 flexible ureteroscopy cases with all data available were analysed. Sixty-eight patients with postoperative UTI were identified. After the matchpair, 136 patients were enrolled in the study. According to match pairing the demographic and peri-operative characteristics in the two groups were similar. In our study, we found that the mean waiting period was 12.8 ± 6.9 days in the group without postoperative infection. However, this period was statistically longer in the group which occured postoperative infection as 17.0 ± 7.3 days. If the awaiting period is longer than 2 weeks, the risk of postoperative UTI rates increase with statistical difference (p=0.006). When subgroup analysis was performed according to the weeks, we found that there was no difference between the two groups in patients with Δ-day duration of 1 week. However, we found a statistically significant difference between performing f-URS before the second week and after the second week (Table 1).
CONCLUSION: The current study is the first to investigate the impact of awaiting period for flexible ureteroscopy in the literature. In brief, elongation of Δ-day is an important parameter in the occurence of postoperative UTI. According to our subgroup analysis, postoperative UTI is more frequent especially if Δ-day >14 days. We should either perform the operation in the early period after the urine culture analysis or do the urine culture analysis shortly before the operation.