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Comparison of safety and efficacy of tubeless vs. conventional mini percutaneous nephrolithotomy in patients with Escherichia coli bacteriuria

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Abstract

To evaluate the safety and efficacy of tubeless percutaneous nephrolithotomy (PCNL) in patients with Escherichia coli (E. coli) bacteriuria. We conducted a retrospective review of 84 patients with E. coli bacteriuria who underwent PCNL. Patients were divided into two groups according to whether a nephrostomy tube is placed at the end of the procedure. Preoperative clinical data, surgical outcomes, and postoperative complications were compared. Then, regression analysis of factors predicting success rate of PCNL in patients with E. coli bacteriuria was performed. After PCNL, residual fragments ≤ 4 mm were considered as success. At baseline, the two groups were similar with regard to age, gender, BMI, underlying disease, hydronephrosis, stone characteristics, and urinalysis. Postoperative fever occurred in 1 patient (3.8%) in the tubeless PCNL group, and in 5 patients (8.6%) in the conventional PCNL group (p > 0.05). There were no significant differences in terms of successful rate, decrease in hemoglobin, pain scores, blood transfusion, and hospitalization expenses. However, the tubeless PCNL group had significantly shorter operative time (60 vs. 70 min, p = 0.033), indwelling time of catheter (2 vs. 4 days, p < 0.001), and hospital stays (3 vs. 5 days, p < 0.001) than the conventional PCNL group. In the analysis of factors predicting success, the stone diameter, stone burden, and operative time were associated with success rate of PCNL. It is safe and effective to perform tubeless PCNL in patients with E. coli bacteriuria. Compared to conventional PCNL, tubeless PCNL accelerates patient recovery and shortens hospital stays.

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Abbreviations

PCNL:

percutaneous nephrolithotomy

ESBL:

extended-spectrum beta-lactamase

VAS:

Visual Analogue Scale

BMI:

body mass index

SIRS:

systemic inflammatory response syndrome

Hb:

hemoglobin

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Funding

This study was supported by the Scientific Project of Health Commission of Hunan Province (No. B202304055928), Promotion Project of health suitable technology of Health Commission of Hunan Province (No. 202319016258) and the Research and Reform Project of Hospital Administration of University of South China (No. 2021YYGL10).

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Author notes

  1. Shidong Deng and Dayong Guo contribute equally to this work as the co-first authors.

Authors and Affiliations

  1. Department of Urology, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China

    Shidong Deng, Dayong Guo, Lingzhi Liu, Yurou Wang & Huihui Zhang

  2. Department of Urology, Changsha Economic Development Zone Hospital, Changsha, Hunan, 410100, China

    Dayong Guo

  3. Department of Obstetrics, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China

    Kuilin Fei

  4. Institute of Hospital Administration, University of South China, Hengyang, China

    Huihui Zhang

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  1. Shidong Deng
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  2. Dayong Guo
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Contributions

Shidong Deng: project development, study execution, data collection and manuscript writing; Dayong Guo: project development, study execution, data collection and manuscript writing; Lingzhi Liu: data collection, data analysis, and manuscript writing; Yurou Wang: data collection and data analysis; Kuilin Fei: data collection and data analysis. Huihui Zhang: project development, technical guidance, Manuscript editing and funding.

Corresponding author

Correspondence to Huihui Zhang.

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Informed consent was obtained from all individual participants included in the study. All procedures were conducted in accordance with the Declaration of Helsinki, and the study received approval from the First Affiliated Hospital of University of South China ethics committee (No: 2022ll0401001).

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The authors declare no competing interests.

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Deng, S., Guo, D., Liu, L. et al. Comparison of safety and efficacy of tubeless vs. conventional mini percutaneous nephrolithotomy in patients with Escherichia coli bacteriuria. Urolithiasis 52, 59 (2024). https://doi.org/10.1007/s00240-024-01567-2

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