To compare the predictive value of preoperative midstream urine culture (PMUC), intraoperative renal pelvic urine culture (RPUC), and stone culture (SC) for postoperative urinary tract infections (UTIs) following supine-PCNL, highlighting the clinical significance of these comparisons.
Key Findings:
Postoperative UTI occurred in 14.1% of patients (n = 33).
Postoperative fever was noted in 12.4% of patients, significantly higher in UTI-positive patients (72.7%).
No significant differences in age, BMI, diabetes presence, stone size, or surgery laterality between UTI-positive and UTI-negative patients.
Higher proportion of female patients in the UTI-positive group (60.6%).
UTI occurrence was more common among patients with an ASA score of 3.
Interpretation:
Intraoperative cultures (RPUC and SC) may provide better predictive value for postoperative UTIs compared to PMUC, particularly in identifying at-risk patients, which could inform tailored antibiotic prophylaxis.
Limitations:
Retrospective design may introduce selection bias, potentially affecting the reliability of the findings.
Limited generalizability due to single-center study, which may not reflect broader populations.
Potential confounding factors not fully controlled, which could influence the results.
Conclusion:
Intraoperative cultures are crucial for predicting postoperative UTIs after PCNL, emphasizing the need for tailored antibiotic prophylaxis based on culture results, and aligning with existing literature on the topic.
