Early versus delayed ureterolithotripsy following obstructive acute pyelonephritis treatment.

BACKGROUND AND OBJECTIVES: There is no recommendation on the timing of ureterolithotripsy after the treatment of obstructive acute pyelonephritis (APN). The effect of early and delayed ureterolithotripsy on postoperative urinary tract infection (UTI) and other complications was investigated. METHODS: Patients who underwent ureterolithotripsy after obstructive APN treatment between February 2017 and August 2021 were divided into two groups, those operated during hospitalization and those operated within 3 months after discharge. Two groups were compared in terms of stone-free status, postoperative complications, postoperative UTI, and urosepsis rates. RESULTS: Of the 91 patients included in the study, 68 were in the early ureterolithotripsy group, while 23 patients were in the delayed ureterolithotripsy group. The postoperative UTI rate was significantly higher in patients who underwent early ureterolithotripsy (29.4% vs 8.7%, p = 0.045). Patients with postoperative UTI had a higher moderate/severe perinephric fat stranding (PFS) on non-contrast CT at hospital admission (52.2% vs 29.4%, p = 0.048). Among the laboratory parameters, white blood cells were significantly higher in the group with postoperative UTI (21604.5 vs 14728.9, p = 0.042). In the multivariate analysis, early ureterolithotripsy and moderate/severe PFS were independent predictors for postoperative UTI. In the created model, the probability of postoperative UTI after ureterolitripsy after obstructive APN treatment was 3.5% in patients without risk factors, while this rate was 51.9% in patients with both risk factors. CONCLUSION: There is no consensus on the timing of stone removal after treatment of obstructive APN. Early ureterolithoripsy and moderate/severe perinephric fat stranding on non-contrast CT are risk factors for postoperative UTI.

Could twinkling artifact be a parameter in predicting the success of shock wave lithotripsy? A prospective study.

Introduction: It is important to predict success before the treatment of urolithiasis. We aimed to predict the success of shock wave lithotripsy (SWL) by comparing twinkling artifact (TA) revealed through colour Doppler ultrasonography (CDUS) with stone density in non-contrast computed tomography (NCCT). Material and methods: Eighty patients who underwent SWL between January 2021 and January 2022 were included in the study. Patients with stones of 5-20 mm in the renal pelvis and proximal ureter at NCCT were included. Patients' demographics, Hounsfield units (HU) in NCCT, and TA grades in CDUS were recorded. The stone-free rate after SWL, additional treatments, overall success rates, and the association between TA and success rates were evaluated. Results: The mean age was 47.41 ±15.08 years. The mean BMI was 24.49 ±3.67 kg/m2. Twenty-three (28.8%) patients were TA grade 0, 33 (41.2%) patients were grade 1, and 24 (30%) were grade 2. The mean HU of TA grades 0, 1, and 2 of stones were 628 ±107, 864 ±123, and 1166 ±292, respectively. The HU increased along with the increase in the TA grade of the stone (p <0.01). The mean number of SWL sessions was 2.26 ±0.75 in patients with TA grade 0, and 2.92 ±0.40 in patients with TA grade 2. The mean number of SWL sessions increased along with the increase in TA grade (p <0.01). The stone-free rate decreased as the TA grade increased. Stone diameter and TA were the only predictors of SWL success. Conclusions: We think that TA may be useful in predicting SWL success.

Comparison of transcutaneous tibial nerve stimulation versus percutaneous tibial nerve stimulation in category IIIB chronic prostatitis/chronic pelvic pain syndrome: A randomized prospective trial.

BACKGROUND: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a heterogenous condition that impacts the Quality of life severely, and it has multimodal complex treatment options. We aimed to compare the efficacy of two well-described neuromodulation therapies, transcutaneous tibial nerve stimulation (TTNS) versus percutaneous tibial nerve stimulation (PTNS) in the treatment of category IIIB CP/CPPS. METHODS: This study was designed as a randomized prospective clinical trial. We randomized category IIIB CP/CPPS patients into two treatment groups as TTNS and PTNS groups. Category IIIB CP/CPPS was diagnosed by two or four-glass Meares-Stamey test. All patients included in our study were antibiotic/anti-inflammatory resistant. Transcutaneous and percutaneous treatments were applied 30 min sessions for 12 weeks. Patients were evaluated by Turkish-validated National Health Institute Chronic Prostatitis Symptom Index (NIH-CPSI) and visual analogue scale (VAS) initially and after treatment. Treatment success was evaluated within each group and also compared with each other. RESULTS: A total of 38 patients in the TTNS group and 42 patients in the PTNS group were included in the final analysis. The mean VAS scores of the TTNS group were lower than the PTNS group initially (7.11 and 7.43, respectively), (p = 0.03). The pretreatment NIH-CPSI scores were similar between groups (p = 0.07). VAS scores, total NIH-CPSI, NIH-CPSI micturation, NIH-CPSI pain, and NIH-CPSI QoL scores decreased significantly at the end of the treatment in both groups. We found a significantly higher VAS and NIH-CPSI scores decrease in the PTNS group compared to the TTNS group (p < 0.01). CONCLUSION: Both PTNS and TTNS are effective treatment methods in category IIIB CP/CPPS. Comparing the two methods, PTNS provided a higher level of improvement in terms of pain and quality of life.

Primary Epithelioid Angiomyolipoma of Adrenal Gland: Case Report and Literature Review.

Angiomyolipomas (AMLs) are mesenchymal tumours derived from perivascular epithelioid cells. Although AMLs are generally known as benign and extremely rare epithelioid variants of AML, they may be potentially aggressive. Here we present an adrenal epithelioid AML and the literature review. A 64-year-old female patient was diagnosed with a left adrenal mass detected incidentally on ultrasonography. Preoperative abdominal CT (computed tomography) showed a 95×68 mm heterogeneous contrast enhancement mass lesion in the left adrenal gland. The lesion was hormone inactive in the endocrinological evaluation, and left laparoscopic adrenalectomy was performed. The patient was discharged on the 2nd postoperative day. Pathology was reported as epithelioid subtype AML. The patient has no local recurrence or metastasis in the 18-month follow-up period and imaging. Adrenal epithelioid AML is an extremely rare and potentially aggressive variant. According to the literature, open or laparoscopic adrenalectomy seems to be suitable option for disease management.

Oncologic outcomes and predictive factors for progression in pT3a renal cell carcinoma.

OBJECTIVES: We aimed to evaluate oncologic outcomes of pT3a renal cell carcinoma (RCC) patients that treated with radical or partial nephrectomy and identify clinical or pathological factors that predict local recurrence or metastasis. METHODS: In this single center, retrospective study, we evaluated medical records of 856 patients who underwent radical or partial nephrectomy for RCC. Patients who had pT3aN0M0 RCC in final pathology and at least 6 months of follow-up included in the study. Patients' demographic characteristics, laboratory parameters, tumor characteristics and oncological outcomes were recorded. Cancer specific and overall survivals were our primary outcomes. Multivariate analysis was performed to identify factors affecting oncologic outcomes. RESULTS: A total of 86 pT3aN0M0 RCC patients were included final analysis of our study. During the mean 60.75 months follow up, 3 patients (3.5%) had experienced local recurrence and 19 patients (22.1%) had experienced metastasis. Total of 24 patients (27.9%) had died during the follow up. In this population 10-year OS was 70.8%, 10-year PFS was 61.3% and 10-year CSS was 78.4%. In multivariate analysis, chronic renal failure (CRF) was an independent worse prognostic factor for overall survival (p=0.03). Besides this sarcomatoid differentiation was an independent prognostic factor for PFS, CSS and OS (p=<0.001). CONCLUSIONS: Our study investigated the predictive factors for worse oncologic outcomes in pT3aN0M0 RCC patients. Although many factors have predictive value in univariate analysis, only sarcomatoid differentiation have independent predictive value for worse CSS, PFS and OS. Besides sarcomatoid differentiation, CRF is an independent prognostic factor for poor OS.

PTEN Loss and PD-L1 Expression of Different Histological Patterns of Prostate Cancer.

AIMS: Although several studies have evaluated PTEN loss in Prostatic Adenocarcinoma (PCa), PTEN loss correlation with different histological patterns only has a few studies. Although several studies have evaluated PD-L1 expression in PCa and its correlation with Gleason scores, as far as we know, there are no prior studies that have included a comparison between PD-L1 expression and histological patterns of PCa. This study aims to evaluate PTEN loss and PD-L1 expression by immunohistochemistry in different histological patterns of PCa. METHODS: The current study included consecutive 98 radical prostatectomy specimens with 151 foci with different Gleason Grade (GG) patterns. RESULTS: The highest frequency of PTEN loss was observed in GG4 cribriform and glomeruloid patterns (59.3%, p < 0.001). Combined score (CS) PD-L1 positivity was observed in fourteen patients (14.2%). Tumor cell (TC) and tumor-associated inflammatory cells (IC) PD-L1 positivity was observed in 10 (10.2%) and 7 (7.1%) patients. The highest frequency of PD-L1 expression was observed in the GG5 pattern, and between GG4 patterns, the irregular pattern had the highest PD-L1 positivity. CONCLUSIONS: In conclusion, in our cohort of consecutive unselected cases of prostatic carcinoma, we observed the highest PTEN loss rate in the GG4 cribriform and glomeruloid pattern and the highest PD-L1 expression rate in the GG5 and GG4 irregular patterns. These results may predict molecular differences between different histological patterns in PCa and may be used to inform a treatment decision. Future studies should investigate these differences between histological patterns of PCa to predict response to immunotherapy in larger cohorts.

Accuracy of Inchworm Sign on Diffusion-Weighted MRI in Differentiating Muscle-Invasive Bladder Cancer.

BACKGROUND: Inchworm sign is a finding on diffusion-weighted magnetic resonance imaging (DWI-MRI) and is used to better stratify T-staging in muscle invasive (MIBC) and non-muscle-invasive bladder cancer (NMIBC). An uninterrupted low submucosal signal on DWI, defined as inchworm sign (IS), indicates NMIBC. OBJECTIVE: We aimed to define the diagnostic accuracy of IS in primary bladder cancer, as well as find agreement between the urologists and the radiologist. METHODS: Between December 2018 and December 2020, we retrospectively analyzed 95 primary bladder cancer patients who had undergone multiparametric-MRI before transurethral resection. Patients with former bladder cancer history, tumors smaller than 10 mm, and MRI without proper protocol, as well as patients who did not attend follow-up, were excluded. In total, 71 patients' images were evaluated by a genitourinary specialist radiologist and two urologists. Sensitivity, specificity, positive and negative predictive values of IS and VI-RADS in differentiating MIBC and NMIBC, and interreader agreement between the radiologist and urologists were analyzed. RESULTS: During follow-up, 38 patients (53.5%) were IS-positive, while 33 patients (46.5%) were negative. Among the 33 patients with negative IS, 14 patients (42.4%) had MIBC. Meanwhile, two out of the 38 IS-positive patients (5.3%) had MIBC (p = 0.00). Sensitivity, specificity, and positive and negative predictive values of IS in predicting MIBC were 87.5%, 63.6%, 41.2%and 94.6%, respectively. The interobserver agreement between the urologists and radiologist was almost perfect ( K  = 0.802 and K  = 0.745). CONCLUSION: The absence of IS on DWI is useful in differentiating MIBC from NMIBC. It is a simple finding that can be interpreted by urologists.

Thermal intravesical chemotherapy in adjuvant treatment of high risk non-muscle invasive bladder cancer. / Quimioterapia intravesical térmica como tratamiento adyuvante en pacientes de cáncer de vejiga alto riesgo no-musculoinvasivos.

OBJECTIVES: To evaluate the oncological results of hyperthermic Mitomycin C (MMC) in adjuvant treatment of high-risk non-muscle invasive bladder cancer and to assess its side-effect profile. METHODS: Patients who were followed up in two reference university hospitals due to high-risk non-muscle invasive bladder tumors were included in the study. High-risk patients according to the EAU non-muscle invasive bladder cancer guideline, patients who were rejected early cystectomy, patients who could not be treated with BCG due to a shortage, and patients for whom the cystectomy would be too risky due to their comorbidities were included in the study. All patients were followed up forat least 24 months with physical examination, cystoscopy, and urine cytology at 3-month intervals. Transurethral tumor resection was performed in all patients and a non-muscle invasive urothelial carcinoma was diagnosed pathologically. Hyperthermic MMC was administered with Synergo system SB-TS 101. Records were kept prospectively and evaluated retrospectively. RESULTS: Fifty-eight high-risk group patients 18 (31%) of whom were at pTa stage and 40 (69%) at pT1 stage were included in the study. During a mean follow-up of 42 months, 34 (58%) patients had recurrence, while 5 (8%) patients progressed to muscle-invasive disease. Eleven (19%) of the patients under went radical cystectomy. The mean time to relapse was 10 months (3-34 months), and the mean time to progression was 41 months (6-87 months). Five-year overall survival, cancer-specific survival, progression-free survival, and relapse-free survival of the patients were 76%, 88%, 90% and 38%, respectively. Multifocality alone was found to be an independent risk factor (HR: 0.26; 95% Cl: 0.08-0.78; p=0.016) affecting recurrence. The observed side effects included tachycardia, cystitis, dysuria, macrohematuria, procedure-related pain, and allergic skin reactions. Treatment had to be discontinued in one patient due to a diffuse skin reaction. CONCLUSIONS: Thermal intravesical MMC therapyis a safe treatment and it could be effective treatment option in preventing disease progression in patients with high risk and non-muscle invasive bladder cancer with unsuccessful Bacillus Calmette-Guérin (BCG) or who could not be treated with BCG for other reasons.

OBJETIVOS: Evaluar los resultados oncológicos de Mitomicina C hipertérmica en tratamiento adyuvante para el cáncer de vejiga de alto riesgono-musculoinvasivo y para evaluar el perfil de efectos secundarios.MÉTODOS: Se incluyeron en el estudio pacientes evaluados en dos centros universitarios de referencia por cáncer de vejiga no-musculoinvasivo de alto riesgo. Fueron incluídos en el estudio los pacientes de alto riesgo según las guías europeas de cáncer de vejiga no-musculoinvasivo, pacientes que no aceptaron la cistectomía precoz o pacientes en los que la cistectomía implicaría demasiado riesgo quirúrgico debido a las comorbilidades. Todos los pacientes fueron seguidos como mínimo por 24 meses con exploración física, cistoscopia y citología de orina en intervalos de 3 meses. La resección transuretral de tumores se realizó en todos los pacientes y el diagnóstico anatomopatológico de carcinoma urotelial no-musculoinvasivo fue determinado. La MMC hipertermia se administró con el sistema Synergo SB-TS101. Los datos se reportaron prospectivamente y retrospectivamente. RESULTADOS: 58 pacientes de alto riesgo, 18 (31%) de los cuales fueron pTa y 40 (69%) pT1 fueron incluidos en el estudio. Durante la media de seguimiento de 42 meses, 34 (58%) recurrieron, mientras que 5 (8% )progresaron a musculo-invasivo. 11 (19%) de los pacientes recibieron una cistectomía radical. La mediana de tiempo a la recidiva fue de 10 meses (3-34 meses) y la mediana a la progresión fue de 42 meses (6-87 meses). La supervivencia global, cáncer-especifica, libre de progresión y libre de recurrencia a 5 años fue de 76%, 88%, 90% y 38%, respectivamente. La multifocalidad fue un factor de riesgo independiente (HR:0,26; 95% Cl: 0,08-0,78; p=0,016) afectando la recurrencia. Los efectos secundarios observados fueron la taquicardia, cistitis, disuria, macrohematuria, dolor con el procedimiento y reacción alérgica. El tratamiento tuvo que pararse en un paciente debido a una reacción cutánea difusa. CONCLUSIONES: La terapia con Mitomicina C térmica es un tratamiento seguro y puede ser un tratamiento efectivo para la prevención de la progresión en pacientes de alto riesgo no-musculoinvasivo en los que la BCG ha fallado o que no se pueden tratar con BCG por otras razones.

Effect of focal and diffuse hypervascularization as cystoscopic findings on predicting intravesical therapy response in patients with bladder pain syndrome.

OBJECTIVE: To define the relationship between cystoscopic findings, including novel findings such as the hypervascularization, of bladder pain syndrome/interstitial cystitis (BPS/IC) and the response to intravesical therapy. MATERIAL AND METHODS: We retrospectively evaluated cystoscopy findings in patients who had a preliminary diagnosis of BPS/IC. All patients received early intravesical combined therapy (ICT), ie, within 2 hours after hydrodistention. Additionally, ICT was continued according to our protocol. Cystoscopic findings were classified as glomerulations, hypervascularization, and Hunner's lesion (HL). The therapy responses were evaluated at 1st, 3rd, 6th, and 12thmonths using the visual analog scale (VAS), O'Leary/Sant interstitial cystitis symptom index (ICSI), and interstitial cystitis problem index (ICPI) scores. RESULTS: Out of 61 patients, HL was diagnosed during cystoscopy in six (9.8%) patients, glomerulations in 35 (57.4%) patients, and hypervascularization in 15 (24.6%) patients. No pathological findings were defined in five (8.2%) patients. In the glomerulation and hypervascularization group, the median VAS, ICSI, and ICPI scores were lower than those in the preoperative period in the follow-up. In patients with HL, the median VAS scores were lower in the entire follow-up compared to the preoperative period, with an increase at 1st year compared to 6th month, and ICSI scores were lower than preoperative period in the entire follow-up, with an increase at 3rd month and 1st year. ICPI scores were also lower during the follow-up, with an increase observed in the 1st year. CONCLUSION: The presence of hypervascularization should be defined since it might show different characteristics that may affect the ICT response. Patients with glomerulations might be good candidates for early combined intravesical therapy.

The effect of shock wave lithotripsy and retrograde intrarenal surgery on health-related quality of life in 10-20 mm renal stones: a prospective randomized pilot study.

The effects of treatment modalities such as retrograde intrarenal surgery (RIRS) and shock wave lithotripsy (SWL) on health-related quality of life (HRQoL) were determined in patients with renal stones between 10 and 20 mm. A total of 120 patients were included in the study and prospectively randomized to RIRS or SWL group. A total of 39 patients experienced treatment failure and finally 81 patients (45 patients in the RIRS group, 36 patients in the SWL group) were analyzed for HRQoL. SF-36 survey was used to determine HRQoL pre-operatively, post-operative day 1 and 1 month. The patient and stone characteristics such as age, gender, stone size, grade of hydronephrosis and body mass index were similar between the two groups. At post-operative day 1, the RIRS group was associated with lower scores of role functioning/physical (p = 0.008), role functioning/emotional (p = 0.047) energy/fatigue (p = 0.011), social functioning (p = 0.003) and pain (p = 0.003) when compared to the SWL group. At post-operative 1 month, only pain and emotional well-being scores (p = 0.012 and p = 0.011, respectively) in the RIRS group were statistically lower according to the SWL group. In our study, patients in the SWL group showed more favorable HRQoL scores when compared to the patients in the RIRS group in short-term follow-up.

Clinical characteristics of postoperative febrile urinary tract infections after ureteroscopic lithotripsy in diabetics: Impact of glycemic control. / Características clínicas de las infecciones posoperatorias del tracto urinario febril después de la litotricia ureteroscópica en diabéticos: impacto del control glucémico.

OBJECTIVE: Ureteroscopic lithotripsy (URS) is the current standard choice of treatment for both ureteral and adequate renal stones. Although it is known to be a safe procedure, postoperative febrile urinary tract infection (UTI) is not rare. Especially in diabetic patients, rate of urinary tract infection is higher. Therefore, we aimed to describe the risk factors for UTI following URS in diabetics. MATERIALS AND METHODS: Between January 2017and April 2019, 546 patients who under went ureteroscopic lithotripsy for ureteral and/or renal stones were included. A matched-pair analysis was performed to compare postoperative UTI rates between diabetics and nondiabetics. We retrospectively reviewed the medical records including age, gender, BMI, comorbidities, UTI history, hemoglobin A1c (HbA1c), operating time, stone size and hounsfield unit (HU), preoperative hydronephrosis, ureteroscopic methods and ureteral stenting. Logistic regression analysis was done to determine the risk factors for postoperative UTI in diabetics. RESULTS: In diabetic patients rate of postoperative UTI was 29% (13/45). After matched-pair analysis within the group of non-diabetics, incidence was 11% (5/44) (p=0.04). In univariate analysis, preoperative ureteral stent, UTI history and HbA1c level were the risk factors for UTI after URS in diabetics. UTI history and HbA1clevel were the independent risk factors for developing postoperative UTI in diabetic patients. HbA1c threshold 6.9% afforded 75% sensitivity and 67% specificity for predicting postoperative UTI in diabetics. CONCLUSIONS: Diabetic patients are under greater risk to develop postoperative UTI following URS. Those patients with UTI history and HbA1c level higher than 6.9% must be followed carefully.

OBJETIVO: La litotricia ureteroscópica (URS) es la opción estándar actual de tratamiento para cálculos renales tanto ureterales como adecuados. Aunque se sabe que es un procedimiento seguro, la infección urinaria febril posoperatoria (ITU) no es rara. Especialmente en pacientes diabéticos, la tasa de infección del tracto urinario es mayor. Por lo tanto, nuestro objetivo fue describir los factores de riesgo de IU después de la URS en diabéticos. MATERIALES Y MÉTODOS: Entre enero de 2017 y abril de 2019, se incluyeron 546 pacientes que se sometieron a litotricia ureteroscópica por cálculos ureterales y/o renales. Se realizó un análisis de pares emparejados para comparar las tasas de ITU postoperatorias entre diabéticos y no diabéticos. Revisamos retrospectivamente los registros médicos. Se realizó un análisis de regresión logística para determinar los factores de riesgo de infección urinaria postoperatoria en diabéticos. RESULTADOS: En pacientes diabéticos, la tasa de ITU postoperatoria fue del 29% (13/45). Después del análisis de pares emparejados dentro del grupo de no diabéticos, la incidencia fue del 11% (5/44) (p=0,04). En el análisis univariado, el historial de ITU y el nivel de HbA1c fueron los factores de riesgo de ITU después de la URS en diabéticos. El historial de ITU y el nivel de HbA1c fueron los factores de riesgo independientes para desarrollar ITU postoperatoria en pacientes diabéticos. El umbral de HbA1c del 6,9% proporcionó una sensibilidad del 75% y una especificidad del 67% para predecir la infección urinaria postoperatoria en diabéticos. CONCLUSIONES: Los pacientes diabéticos tienen un mayor riesgo de desarrollar ITU postoperatoria después de la URS. Los pacientes con antecedentes de ITU y un nivel de HbA1c superior al 6,9% deben ser seguidos cuidadosamente.

Clinical characteristics of postoperative febrile urinary tract infections after ureteroscopic lithotripsy in diabetics: Impact of glycemic control / Características clínicas de las infecciones posoperatorias del tracto urinario febril después de la litotricia ureteroscópica en diabéticos: impacto del control glucémico

OBJECTIVE: Ureteroscopic lithotripsy (URS) is the current standard choice of treatment for both ureteral and adequate renal stones. Although it is known to be a safe procedure, postoperative febrile urinary tract infection (UTI) is not rare. Especially in diabetic patients, rate of urinary tract infection is higher. Therefore, we aimed to describe the risk factors for UTI following URS in diabetics. MATERIALS AND METHODS: Between January 2017 and April 2019, 546 patients who underwent ureteroscopic lithotripsy for ureteral and/or renal stones were included. A matched-pair analysis was performed to compare postoperative UTI rates between diabetics and nondiabetics. We retrospectively reviewed the medical records including age, gender, BMI, comorbidities, UTI history, hemoglobin A1c (HbA1c), operating time, stone size and hounsfield unit (HU), preoperative hydronephrosis, ureteroscopic methods and ureteral stenting. Logistic regression analysis was done to determine the risk factors for postoperative UTI in diabetics. RESULTS: In diabetic patients rate of postoperative UTI was 29% (13/45). After matched-pair analysis within the group of non-diabetics, incidence was 11% (5/44) (p = 0.04). In univariate analysis, preoperative ureteral stent, UTI history and HbA1c level were the risk factors for UTI after URS in diabetics. UTI history and HbA1c level were the independent risk factors for developing postoperative UTI in diabetic patients. HbA1c threshold 6.9% afforded 75% sensitivity and 67% specificity for predicting postoperative UTI in diabetics. CONCLUSIONS: Diabetic patients are under greater risk to develop postoperative UTI following URS. Those patients with UTI history and HbA1c level higher than 6.9% must be followed carefully

OBJETIVO: La litotricia ureteroscópica (URS) es la opción estándar actual de tratamiento para cálculos renales tanto ureterales como adecuados. Aunque se sabe que es un procedimiento seguro, la infección urinaria febril posoperatoria (ITU) no es rara. Especialmente en pacientes diabéticos, la tasa de infección del tracto urinario es mayor. Por lo tanto, nuestro objetivo fue describir los factores de riesgo de IU después de la URS en diabéticos. MATERIALES Y MÉTODOS: Entre enero de 2017 y abril de 2019, se incluyeron 546 pacientes que se sometieron a litotricia ureteroscópica por cálculos ureterales y/o renales. Se realizó un análisis de pares emparejados para comparar las tasas de ITU postoperatorias entre diabéticos y no diabéticos. Revisamos retrospectivamente los registros médicos. Se realizó un análisis de regresión logística para determinar los factores de riesgo de infección urinaria postoperatoria en diabéticos. RESULTADOS: En pacientes diabéticos, la tasa de ITU postoperatoria fue del 29% (13/45). Después del análisis de pares emparejados dentro del grupo de no diabéticos, la incidencia fue del 11% (5/44) (p = 0,04). En el análisis univariado, el historial de ITU y el nivel de HbA1c fueron los factores de riesgo de ITU después de la URS en diabéticos. El historial de ITU y el nivel de HbA1c fueron los factores de riesgo independientes para desarrollar ITU postoperatoria en pacientes diabéticos. El umbral de HbA1c del 6,9% proporcionó una sensibilidad del 75% y una especificidad del 67% para predecir la infección urinaria postoperatoria en diabéticos. CONCLUSIONES: Los pacientes diabéticos tienen un mayor riesgo de desarrollar ITU postoperatoria después de la URS. Los pacientes con antecedentes de ITU y un nivel de HbA1c superior al 6,9% deben ser seguidos cuidadosamente