aGiresun University, Faculty of Medicine, Department of Urology, Giresun, Turkey bMinistry of Health, Kayseri City Hospital, Department of Urology, Kayseri, Turkey cGiresun University, Faculty of Medicine, Department of Radiology, Giresun, Turkey
Objective: Perirenal fat stranding (PFS) is linear areas of soft-tissue attenuation in the perirenal space on non-contrast computed tomography. The present study aimed to investigate whether PFS is associated with infectious complications after ureterorenoscopy (URS) in patients with ureteral calculi in any location. Methods: The data of 602 patients with ureteral stones who underwent URS were analyzed retrospectively. The patients were divided into two groups as Group 1 (PFS not detected) and Group 2 (PFS detected). Gender, and age of patients, size, side, and location of the stone, operation time, double-J stent insertion status, perioperative ureter injury, postoperative infection after URS and related complications, and duration of hospital stay were compared. Results: While PFS was not detected in 530 patients, PFS was detected in 72 patients. The mean age, male/female ratio, side and localization of the stones, operation time, and perioperative insertion of the double-J after lithotripsy were statistically similar (p>0.05). The median stone diameter was smaller in Group 2 (9 mm vs. 8 mm) (p=0.033). Fever was observed in 30 and 38 patients in Group 1 and Group 2, respectively (p=0.0001). Urinary tract infection was detected in 24 and 27 patients in Group 1 and Group 2, respectively (p=0.0001). The urosepsis did not occur in any patients in Group 1, whereas 8 (11.1%) patients in Group 2 experienced urosepsis (p=0.0001). Conclusion: According to the results of the present study, patients with ureteral stones accompanied by PFS are much more prone to ureteral injuries and infectious complications such as urinary tract infection, fever, and sepsis after URS.
. [J]. Asian Journal of Urology, 2022, 9(3): 307-312.
Erhan Demirelli,Ercan Öğreden,Cemil Bayraktar,Alptekin Tosun,Ural Oğuz. The effect of perirenal fat stranding on infectious complications after ureterorenoscopy in patients with ureteral calculi. Asian Journal of Urology, 2022, 9(3): 307-312.
Demographic information of patients and complications
Group 1 (n=530)
Group 2 (n=72)
p-Value
Fever, n
0.0001a
Absent
500
34
Exist
30
38
Urinary infection, n
0.0001a
Absent
506
45
Exist
24
27
Urosepsis, n
0.0001b
Absent
530
64
Exist
0
8
Gender, n
0.021a
Female
191
16
Male
339
56
Stone side, n
0.820a
Left
253
35
Right
275
37
Bilateral
2
0
Stone localization, n
0.145a
Lower
345
55
Middle
126
12
Upper
59
5
Postoperative double-J stent insertion, n
0.904a
Absent
375
52
Exist
155
20
Mucosal injury, n
0.0001b
Absent
517
54
Exist
13
18
Ureteral perforation, n
0.0001b
Absent
527
66
Exist
3
6
Hydronephrosis, n
0.076a
Absent
148
13
Exist
382
59
Age, median, year
44
43
0.772c
Stone size, median, mm
9
8
0.033c
Operation time, median, min
30
30
0.889c
Postoperative length of hospital stay, median, day
1
2
0.033c
Patients' data and risk factors
Complication
p-Value
Absent
Exist
Hydronephrosis, n
0.688a
Absent
148
13
Exist
382
59
PFS, n
0.002a
Absent
467
63
Exist
53
19
Gender, n
0.045a
Female
187
20
Male
333
62
Postoperative double-J stent insertion, n
0.189a
Absent
374
53
Exist
146
29
Age, mean, year
44.9
44.2
0.685b
Stone size, mean, mm
8.8
10.4
<0.001b
Operation time, mean, min
38.4
42.2
0.059b
Interval time, mean, day
14.4
14.9
0.867b
Risk factor for infectious complication
Odds ratio
p-Value
95% confidence interval
Age, mean, year
0.992
0.529
0.969-1.016
Gender
1.032
0.930
0.516-2.064
Stone size, mean, mm
1.089
0.041
1.003-1.182
Interval timea, mean, day
1.002
0.910
0.969-1.036
Operation time, mean, min
1.008
0.358
0.991-1.026
Postoperative double-J stent insertion
2.765
0.013
1.245-6.143
PFS
49.757
<0.001
21.756-113.794
Presence of impacted stones
7.765
<0.001
3.146-19.167
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