ABSTRACT
Introduction & Objectives: Indwelling ureteric stents are valuable devices used in emergency drainage of upper urinary tract obstruction due to ureteric stones. However, stents can cause significant morbidity with infections, encrustations and blockages. In the study we look at the outcomes of pre-operative stent dwell time on infectious complications following ureteroscopy and laser fragmentation (URSL). Materials & Methods: Data was retrospectively collected for outcomes of URSL from 3 European endourology centres for patients with preoperative indwelling ureteric stents. We included data for patient details, stone demographics, operative details, stone free rate (SFR), outcomes and complications between 2011 and 2020. Patients were divided into two groups based on the stent dwell time: group 1 (<6 months) and group 2 (≥6 months). Descriptive statistics were used to determine the rate of early post-operative infectious complications (defined as the presence of fever?) and ICU access. Binomial logistic regression analysis were used to explore the relationship between stent dwelling time and post-operative early infectious complications. (SPSS v.24). Results: There were 501 patients undergoing URSL in the study period, with 429 and 72 patients in groups 1 and 2 respectively (Table 1). The mean age and operative time in groups 1 and 2 were 71±30 years and 64±22 years, and 51±28 minutes and 59±31 minutes respectively. Infectious complications and ICU admissions were seen in 32 (8%) and 3 (0.7%), and 22 (31%) and 1 (1.4%) in groups 1 and 2 respectively. Stent dwell time of ≥6 months carried significantly higher risk for febrile UTI post URSL (RR=5.45, 95% CI: 2.94-10.10, p<0.001). (Table Presented) Conclusions: Although the overall risk of infectious complication rates from URSL were low, longer indwelling stent time significantly increases the risk of post-operative infections, of which a small proportion of patients end up in ICU. We would recommend having the stent dwell time as short as possible and not to exceed a 6 months’ time period, and our findings will help prioritise these patients in the post-COVID era.
ABSTRACT
Introduction & Objectives: In the era of SARS-CoV-2 pandemic infection, a special attention has been dedicated to largely observed viral infections. Of those, cytomegalovirus (CMV) is a higlhy prevalent infection in humans. The role of CMV infection in terms of male fertility outcomeshas been poorly investigated and it is still debated. We aimed to investigate the association between CMV infection and sperm parameters in acohort of infertile white-European men.Materials & Methods: Complete demographic and laboratory data from 1679 infertile men were analysed. Socio-demographic data, serumhormones levels and CMV serology (IgM and IgG) were investigated in all participants. Semen analyses were based on the 2010 WHO referencecriteria. Health-significant comorbidities were scored with the Charlson Comorbidity Index (CCI). Descriptive statistics were used to test theassociation between CMV infection and sperm parameters. Logistic regression analyses tested CMV infection as a potential predictor for abnormalsperm parameters.Results: Median (IQR) age was 37 (33-41) years and median BMI was 25.2 (23.4-27) kg/m2. Of 1679 infertile men, 149 (8.1%) had CCI≥1,488 (29.1%) were smokers. Median semen volume was 3 (2-4) ml, sperm concentration 11 (2.2-34.1) x106/ml, sperm progressive motility 24%(9-38%) and normal sperm morphology 3% (1-11%). Of 1679, 57 (3.4%) and 703 (41.9%) were positive to CMV IgM and IgG, respectively. Therewere no differences in clinical and sperm parameters between men with serological tests suggestive for either current or historical CMV infectioncompared with CMV negative men (Fig. 1). Adjusted and unadjusted logistic regression analyses revealed that both CMV IgG and IgM status wasnot significantly associated with altered sperm parameters.Conclusions: Findings from this cross-sectional real-life study showed that 4 out of 10 men presenting for couples’ infertility have had CMVinfection. Current or previous CMV infections were not associated with an increased risk of abnormal sperm parameters in infertile men. Aprospective case-control study is needed to further confirm these observations.(Figure Presented)(Figure Presented)(Figure Presented)(Figure Presented)
ABSTRACT
Introduction: Indwelling ureteric stents, usually inserted for emergency drainage of an obstructed system, can cause significant morbidity with infections. We aimed to assess pre-operative stent dwell time on infectious complications following ureteroscopy and laser fragmentation (URSL). Material and Methods: Data was retrospectively collected for outcomes of URSL from 3 European endourology centres for patients with pre-operative indwelling ureteric stents. We included data for patient details, stone demographics, operative details, stone free rate (SFR), outcomes and complications between 2011 and 2020. Patients divided into group 1 (<6 months stent dwell time) and group 2 (6 months). Primary outcomes were early post-operative infectious complications (febrile UTI) and ICU access. Analysis with binomial logistic regression (SPSS v.24). Results: 501 patients were included (group 1, n=429;group 2, n=72) [Table 1]. Mean age and operative time in groups 1/2 were 71-30 years and 64-22 years, and 51-28 minutes and 59-31 minutes. Febrile UTI and ICU admissions were seen in 32(8%) and 3(0.7%), and 22(31%) and 1(1.4%) in groups 1/2 respectively. Stent dwell time of 6 months carried significantly higher risk for febrile UTI post URSL (RR=5.45, 95% CI: 2.94-10.10, p<0.001) [see fig 1]. Conclusion: Although the overall risk of infectious complication rates from URSL were low, longer indwelling stent time significantly increases the risk of post-operative infections. We would recommend having the stent dwell time as short as possible and not to exceed 6 months. Our findings will help prioritise these patients in the post-COVID era.