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• W2040447745 abstract "No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Mar 2002FACTORS PREDISPOSING TO URINARY TRACT INFECTION AFTER J URETERAL STENT INSERTION ELIJAH O. KEHINDE, VINCENT O. ROTIMI, KHALEEL A. AL-AWADI, HAMDY ABDUL-HALIM, FAREEDA BOLAND, ADEL AL-HUNAYAN, and ALEYAMMA PAZHOOR ELIJAH O. KEHINDEELIJAH O. KEHINDE More articles by this author , VINCENT O. ROTIMIVINCENT O. ROTIMI More articles by this author , KHALEEL A. AL-AWADIKHALEEL A. AL-AWADI More articles by this author , HAMDY ABDUL-HALIMHAMDY ABDUL-HALIM More articles by this author , FAREEDA BOLANDFAREEDA BOLAND More articles by this author , ADEL AL-HUNAYANADEL AL-HUNAYAN More articles by this author , and ALEYAMMA PAZHOORALEYAMMA PAZHOOR More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)65294-9AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We determined the group of patients most likely to have bacterial infection or colonization of J stents inserted to relieve ureteral obstruction. Materials and Methods: Midstream urine from 250 consecutive patients who required indwelling J stent insertion obtained before stent insertion and on the day of stent removal was analyzed by microbiological testing. At stent removal 3 to 5 cm. of the stent tip located inside the bladder was also sent for culture. Patient sex, duration of stent insertion and systemic disease, such as diabetes mellitus, chronic renal failure or diabetic nephropathy, were recorded. Patients without systemic disease were classified as normal. The rates of bacteriuria, stent colonization and symptomatic urinary tract infection were compared in patients with and without systemic disease. Results: Of the 250 patients studied 180 (72%) were men and 70 (28%) were women, while 152 (60.8%) had no systemic disease, 27 (10.8%) had diabetes mellitus, 53 (21.1%) had chronic renal failure and 18 (7.2%) had diabetic nephropathy. The bacteriuria rate was 4.2% for stents removed within 30 days and 34% for stents removed after 90 days (p <0.001). Overall the bacteriuria rate in women was 24.3% compared with 13.9% in men (p <0.06). The rate of bacteriuria in normal patients was significantly lower (3.3%) than in patients with diabetes mellitus, chronic renal failure and diabetic nephropathy (33.3%, 39.6% and 44.4%, respectively, p <0.001). The colonization rate of the tip of the stent was higher in women (64.3%) than in men (34.7%). The stent was removed prematurely in 9 of the 250 patients (3.6%) because of septicemia, including 7 women (77.8%) with systemic disease. Conclusions: The risk of bacteriuria and colonization of the J stent tip is significantly enhanced by the duration of stent retention, patient sex and the systemic disease, such as diabetes mellitus, chronic renal failure and diabetic nephropathy. These categories of patients should undergo shorter stent retention, antimicrobial prophylaxis and careful followup to minimize infectious complications. References 1 : Ureteral stents: indications, variations and complications.. Urol Clin North Am1988; 15: 481. Google Scholar 2 : Extracorporeal shockwave lithotripsy for large renal calculi: the role of ureteral stents—a randomized trial. J Urol1990; 143: 699. Google Scholar 3 : Steinstrasse: a comparison of incidence with and without ‘J’ stenting and the effect of ‘J’ stenting on subsequent management. BJU Int1999; 84: 618. Google Scholar 4 : The indwelling ureteric stents: a “friendly procedure with unfriendly high morbidity.”. BJU Int2000; 85: 408. Google Scholar 5 : Bacteriuria and colonisation of double-pigtail ureteral stents: long-term experience with 237 patients. J Endourol1995; 9: 469. Google Scholar 6 : Catheter associated bacteriuria.. Urol Clin North Am1986; 13: 735. Google Scholar 7 : Morbidity associated with indwelling internal ureteral stents after shock wave lithotripsy.. J Urol1989; 141: 510. Abstract, Google Scholar 8 : Factors predisposing to bacteriuria during indwelling urethral catheterisation. N Engl J Med1974; 291: 215. 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Abstract, Google Scholar From the Departments of Surgery (Urology Division) and Microbiology, Mubarak Al-Kabeer Teaching Hospital and Faculty of Medicine, Kuwait University, Kuwait© 2002 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byWerneburg G, Hettel D, Lundy S, Adler A, De S, Mukherjee S, Rackley R, Shoskes D and Miller A (2023) Ureteral Stents Harbor Complex Biofilms With Rich Microbiome-Metabolite InteractionsJournal of Urology, VOL. 209, NO. 5, (950-962), Online publication date: 1-May-2023.Fiuk J, Bao Y, Calleary J, Schwartz B and Denstedt J (2014) The Use of Internal Stents in Chronic Ureteral ObstructionJournal of Urology, VOL. 193, NO. 4, (1092-1100), Online publication date: 1-Apr-2015. Volume 167Issue 3March 2002Page: 1334-1337 Advertisement Copyright & Permissions© 2002 by American Urological Association, Inc.Keywordsbacteriuriaurinary tract infectionsbladderstentsureterMetricsAuthor Information ELIJAH O. KEHINDE More articles by this author VINCENT O. ROTIMI More articles by this author KHALEEL A. AL-AWADI More articles by this author HAMDY ABDUL-HALIM More articles by this author FAREEDA BOLAND More articles by this author ADEL AL-HUNAYAN More articles by this author ALEYAMMA PAZHOOR More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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