Nephrolithiasis-associated Bacteriuria: Pre-operative Evaluation of Patients Candidate for Intervention at Faghihi and Namazee Hospitals, Shiraz Universities of Medical Sciences, 2020-2021

Patients who have nephrolithiasis and are candidates for operation may have symptomatic or asymptomatic bacteriuria, which should be treated before any surgical intervention. We evaluated our patients for the prevalence of bacteriuria before surgical intervention.

Between March 2020 and March 2022, a total of 832 patients (489 men and 343 women) with a mean age of 38.4 years, who were candidates for renal stone surgery, were evaluated by tests, including complete blood count, urine analysis, and preoperative culture. In this study, we recorded the bacteriuria (symptomatic or asymptomatic).

Of 832 patients, 594 had the first episode of stone formation and 238 had recurrent diseases. Of these, 784 patients were scheduled for percutaneous nephrolithotomy and 48 patients for open nephrolithotomy. Overall, in the preoperative urine analysis test, 56 cases of bacteriuria were reported, of which 22 cases had positive urine cultures. Of the positive culture cases, 14 were recurrent and 8 were patients who had kidney stones for the first time. The most common microorganism was Escherichia coli (n=15), followed by Klebsiella (n=4), Proteus (n=2), and Pseudomonas (n=1). Only 8 of these patients had symptoms and the rest were asymptomatic. All of these patients received a course of oral antibiotics before the operation.

Bacteriuria is a common finding in patients with nephrolithiasis that seems to be more common in recurrent diseases; therefore, urine culture and appropriate treatment are mandatory before any intervention to prevent serious complications, such as infection, sepsis, and mortality.