García-Aparicio L, Blázquez-Gómez E, Martin O, Krauel L, de Haro I, Rodó J
Sección de Urología Pediátrica, Servicio de Cirugía Pediátrica, Hospital Sant Joan de Déu, Universidad de Barcelona, Barcelona, España.
Hospital Universitario Virgen Macarena, Universidad de Sevilla, Sevilla, España.
Actas Urol Esp. 2015 Jan-Feb;39(1):53-6. doi: 10.1016/j.acuro.2014.04.008. Epub 2014 Jun 18.
To determine the incidence of urinary tract infection in those patients that we have used an ureteral double-J stent as internal diversion after urological procedures.
We reviewed all the medical records of patients who had a ureteral double-J stent after a urological procedure from August 2007 to May 2013. We have analyzed the following data: age, gender, type of prophylaxis, incidence of urinary tract infection (UTI), days of internal diversion with double-J stent, surgical procedure, bacterial characteristics, bacterial sensibility to antibiotics and UTI treatment.
We have used 73 double-J stents as ureteral internal diversion in 67 patients with a mean age of 44.73±57.23. Surgical procedures were 50 laparoscopic Anderson-Hynes pyeloplasties in 49 patients, and 20 high-pressure balloon dilatation of the ureterovesical junction to treat primary obstructive megaureter in 15 patients; and 3 patients with ureterovesical obstruction after endoscopic treatment of vesicoureteral reflux. Forty three stents showed a bacterial colonization in cultures. Pseudomona aeruginosa was present in 9 (20.9%) stents. Only in 12 stents, bacterial colonization was sensible to antibiotic prophylaxis. Stent colonization was higher in boys and younger patients. Four patients had a febrile UTI. Incidence of UTI in younger patients that underwent HBPD of UVJ is higher.
Bacterial colonization is frequent in double-J stents but the incidence of UTI is low. Double-J colonization is higher in younger patients. Patients that underwent HPBD have a higher risk of UTI related with ureteral double J stent.
确定在泌尿外科手术后使用输尿管双J支架作为内引流的患者中尿路感染的发生率。
我们回顾了2007年8月至2013年5月期间泌尿外科手术后放置输尿管双J支架的所有患者的病历。我们分析了以下数据:年龄、性别、预防类型、尿路感染(UTI)发生率、双J支架内引流天数、手术方式、细菌特征、细菌对抗生素的敏感性以及UTI治疗情况。
我们在67例患者中使用了73个双J支架作为输尿管内引流,患者平均年龄为44.73±57.23岁。手术方式包括49例患者的50例腹腔镜Anderson-Hynes肾盂成形术,15例患者的20例输尿管膀胱连接部高压球囊扩张术以治疗原发性梗阻性巨输尿管;以及3例膀胱输尿管反流内镜治疗后输尿管膀胱梗阻患者。43个支架在培养物中显示有细菌定植。9个(20.9%)支架中存在铜绿假单胞菌。仅12个支架中的细菌定植对抗生素预防敏感。男孩和年轻患者的支架定植率更高。4例患者发生发热性UTI。接受输尿管膀胱连接部高压球囊扩张术的年轻患者中UTI发生率更高。
双J支架中细菌定植很常见,但UTI发生率较低。年轻患者中双J支架定植率更高。接受高压球囊扩张术的患者与输尿管双J支架相关的UTI风险更高。