Analysis of Surgical and Serological Risk Factors for Postoperative Urinary Tract Infection Following the Ureteroscopic Treatment of Renal Calculi.

OBJECTIVE To investigate the risk factors of urinary tract infection (UTI) after the ureteroscopic treatment of renal calculi and analyse the correlation amongst serum inflammatory markers, perioperative factors and infection occurrence.

METHODS A retrospective analysis was conducted on patients who underwent ureteroscopic lithotripsy and stone extraction at the authors' hospital. On the basis of postoperative diagnostic criteria, patients were categorised into the infection (n = 60) and noninfection (n = 150) groups. The serum levels of C-reactive protein (CRP), procalcitonin (PCT), lipopolysaccharide (LPS), endotoxin (ET) and interleukin-8 (IL-8) were measured preoperatively and postoperatively in both groups. In addition, the maximum stone diameter, operative time and postoperative catheterisation duration were recorded. The correlations amongst serum markers, perioperative factors and UTI were analysed, and univariate and multivariate logistic regression analyses were performed to identify independent risk factors.

RESULTS No significant differences in baseline characteristics or preoperative serum markers were found between the two groups (p > 0.05). The postoperative serum levels of CRP, PCT, LPS, ET and IL-8 were significantly higher in the infection group than in the noninfection group (p < 0.05). Maximum stone diameter did not differ significantly between groups (p > 0.05). However, operative time and postoperative catheterisation duration were markedly longer in the infection group (p < 0.05) than in the noninfection group. Postoperative UTI showed a positive correlation with CRP, PCT, LPS, ET, IL-8, operative time and catheterisation duration (p < 0.001). Multivariate logistic regression analysis identified PCT, IL-8 and postoperative catheterisation duration as independent risk factors for infection (p < 0.05). Although CRP, ET and operative time did not reach statistical significance, all had odds ratio > 1, suggesting a potential association with increased infection risk.

CONCLUSIONS Postoperative UTI following ureteroscopic lithotripsy is closely associated with elevated serum inflammatory markers and perioperative factors. Increased PCT and IL-8 levels, as well as prolonged postoperative catheterisation, were identified as independent risk factors. Monitoring perioperative inflammatory indicators and optimising surgical and catheter management may reduce the incidence of postoperative UTI and provide a basis for individualised preventive strategies in clinical practice.