Back to Program


Post-operative antibiotics are not necessary after ureteroscopic stone treatment
Brian H. Eisner, MD1, Michael P. Kurtz, MD1, Boris Gershman, MD1, Olga Arsovska, BA2, Ryan F. Patterson, MD2, Ben H. Chew, MD2.
1Massachusetts General Hospital, Boston, MA, USA, 2University of British Columbia, Vancouver, BC, Canada.

BACKGROUND: Urinary tract infections after ureteroscopic stone treatment are reported to occur in 2-25% of cases. The majority of these studies reviewed patients who received post-operative antibiotics for several days. The purpose of this study was to evaluate the rate of urinary tract infection after ureteroscopic stone treatment for which post-operative antibiotics were not administered.
METHODS: A retrospective review was performed of consecutive patients at two institutions. All patients were given a single dose of antibiotics prior to ureteroscopic stone treatment (cefazolin, vancomycin, or fluroquinolone). Patients were excluded if they had an indwelling stent at the time of ureteroscopy or if they were treated for a urinary tract infection within the 3 months prior to ureteroscopy.
RESULTS: Fifty-five patients (male:female ratio of 17:38) were included in the study. Two (3.6%) of patients developed urinary tract infections in the post-operative period, which were both treated successfully with antibiotics. Urine cultures were positive for mixed bacteria and enteroccoccus respectively. Mean stone diameter was 7.1 mm (SD 3.5). Laser lithotripsy was performed in 84% of cases, while basket extraction alone was performed in 16% of cases. Ureteral access sheath was used in 36% of cases, and ureteral stent was placed in 89% of cases. Stone analysis was available in 56% of cases, and all were calcareous stones. Mean time to follow up was 23 days (SD 29).
CONCLUSIONS: The post-operative urinary tract infection rate in this study (4%) was consistent with what is reported in the literature for ureteroscopic stone treatment. Our data suggests that post-operative antibiotics may not improve infection rates after ureteroscopic stone treatment.


Back to Program