Risk factors for urological infection after laparoscopic ureterolithotomy.

OBJECTIVE

To investigate and analyze the risk factors of urological infection after laparoscopic ureterolithotomy.

METHODS

In this retrospective study, 312 patients who underwent laparoscopic ureterolithotomy were included. Among them, 164 patients developed urological infection post-surgery. Key risk factors for urological infection were identified using univariate and multivariate regression analyses. A clinical nomogram was constructed based on these factors, and its predictive accuracy was assessed using the concordance index (C-index) and calibration plot.

RESULTS

Univariate and multivariate regression analyses identified age >75 years old (95% CI 0.007-0.340; P=0.002), operation time ≥60 min (95% CI 4.506-90.528; P<0.001), postoperative catheter indwelling time >7 days (95% CI 2.315-6.060; P<0.001), diabetes mellitus (95% CI 4.051-24.682; P<0.001), and hospital stay >7 days (95% CI 1.600-37.144; P=0.011) as independent risk factors for urological infection after laparoscopic ureterolithotomy. Those factors were used to construct a predictive nomogram. The regression model was established as: logit (P) = -6.820 + 0.216 * age + 0.312 * operation time + 0.661 * postoperative indwelling catheter time + 0.433 * diabetes mellitus + 0.671 * hospital stay. The calibration curve demonstrated excellent accuracy of the nomogram model. Decision curve analysis indicated that the model is clinically applicable for threshold probabilities ranging from 20% to 75%.

CONCLUSIONS

Age >75 years old, operation time ≥60 min, postoperative indwelling catheter time >7 days, diabetes mellitus, and hospital stay >7 days are independent risk factors for urological infection after laparoscopic ureterolithotomy. Effective monitoring, management, and predictive measures for high-risk patients should significantly reduce the incidence of urological infection.