Febrile complications following insertion of 100 double-J ureteral stents.
OBJECTIVE
Implanted foreign bodies are associated with a higher risk of infection. Little has been published on infectious complications associated with ureteral double-J stents. The aim of this study was to define risk factors and characterize the febrile complications of the insertion of double-J stents.


METHODS
One hundred consecutive cases of retrograde stent insertion (55 men and 45 women) were evaluated retrospectively. Eighty-one patients had an obstructing stone, either in the ureter or at the ureteropelvic junction; 10 had an obstructing tumor; and 9 had hydronephrosis and pain without calculi. Risk assessment was calculated for two major categories: urgent (N = 47) and elective (N = 53) insertion. Potentially confounding factors such as age, sex, accompanying medical problems, and types of prophylaxis were assessed. All but six patients received prophylactic antibiotics prior to stent insertion.


RESULTS
All thirteen patients who had fever at the initial evaluation underwent urgent stent insertion. Of the 87 afebrile patients (53 elective and 34 urgent insertions), 22 (25%) developed fever (> or = 38 degrees C) after the procedure. Fever developed in 19 (56%) of the 34 urgent-insertion group who were not originally febrile as opposed to 3 (6%) of the elective-insertion group (P < 0.001). Six of these 22 patients (27%) had a positive urine culture after insertion. None had a positive blood culture, including the 13 patients who underwent the procedure while febrile.


CONCLUSIONS
Urgent insertion of a double-J stent is associated with a high risk of fever but a favorable outcome.
Paz
Alona
A
Department of Infectious Disease, Bnai Zion Medical Center, and the Rappaport Faculty of Medicine, Technion, Haifa, Israel. Alona.Paz@b-zion.org.il
Amiel
Gilad E
GE
Pick
Neora
N
Moskovitz
Boaz
B
Nativ
Ofer
O
Potasman
Israel
I
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019072:Antibiotic Prophylaxis; D002648:Child; D002675:Child, Preschool; D017558:Elective Surgical Procedures; D004630:Emergencies; D005260:Female; D005334:Fever / Q000382:microbiology*; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis; D006801:Humans; D006869:Hydronephrosis / Q000601:surgery; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000382:microbiology*; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects* / Q000382:microbiology; D014517:Ureteral Obstruction / Q000601:surgery*