Post-ureteroscopy febrile urinary tract infections are linked to pre-operative stent dwell time: Results from three European endourology centres

Introduction: Indwelling ureteric stents, usually inserted for emergency drainage of an obstructed system, can cause significant morbidity with infections. We aimed to assess pre-operative stent dwell time on infectious complications following ureteroscopy and laser fragmentation (URSL). Material and Methods: Data was retrospectively collected for outcomes of URSL from 3 European endourology centres for patients with pre-operative indwelling ureteric stents. We included data for patient details, stone demographics, operative details, stone free rate (SFR), outcomes and complications between 2011 and 2020. Patients divided into group 1 (<6 months stent dwell time) and group 2 (6 months). Primary outcomes were early post-operative infectious complications (febrile UTI) and ICU access. Analysis with binomial logistic regression (SPSS v.24). Results: 501 patients were included (group 1, n=429;group 2, n=72) [Table 1]. Mean age and operative time in groups 1/2 were 71-30 years and 64-22 years, and 51-28 minutes and 59-31 minutes. Febrile UTI and ICU admissions were seen in 32(8%) and 3(0.7%), and 22(31%) and 1(1.4%) in groups 1/2 respectively. Stent dwell time of 6 months carried significantly higher risk for febrile UTI post URSL (RR=5.45, 95% CI: 2.94-10.10, p<0.001) [see fig 1]. Conclusion: Although the overall risk of infectious complication rates from URSL were low, longer indwelling stent time significantly increases the risk of post-operative infections. We would recommend having the stent dwell time as short as possible and not to exceed 6 months. Our findings will help prioritise these patients in the post-COVID era.