Endocrine Abstracts

Introduction: The recent advent of flexible ureteroscopy made endoscopic approach to kidney and proximal ureteral calculi evolve to a real effective procedure. However, this technique is not free of postoperative complications. The aim this study was to assess the predictive factors of septic postoperative complications following flexible ureteroscopy for upper urinary tract stones.

Methods: This is a descriptive retrospective study concerning 92 patients who underwent flexible ureteroscopy for renal and proximal ureteral stones in the urology department of the military hospital of instruction of Tunis between January 2015 and December 2021. Septic complication we defined as the occurrence of postoperative fever, urosepsis, septic shock or death. We used multivariate logistic regression to assess predictive factors of septic postoperative complications.

Results: The mean age was 50 years [20 - 82]. Regarding the medical history of our patients: Diabetes was found in 29 cases (32%), occupying the first place, followed by high blood pressure in 24 cases (26%) and chronic renal failure (20%). We identified postoperative complications following 26 interventions (28%) of which 13% were septic. Predictive factors of postoperative Sepsis after flexible ureteroscopy were: Diabetes (P = 0.032). a history of urolithiasis (P = 0.023). a history of extracorporeal shock wave lithotripsy (P = 0.009). In our study, a quarter of diabetic patients had developed postoperative sepsis. This complication was found in only 7.9% of non-diabetic patients. Statistically, the difference was significant (P = 0.032).

Conclusion: In light of our studies, diabetic patients have a significantly higher risk of occurrence of postoperative infectious complications. This population may require specific perioperative preparatory measures to reduce operative morbidity.