Factors affecting fever following percutaneous nephrolithotomy: a prospective clinical study.
OBJECTIVE
To evaluate the preoperative and intraoperative factors that might affect development of fever following percutaneous nephrolithotomy (PCNL) and to investigate the clinical significance of intraoperative microbiologic evaluation in managing postoperative infectious complications.


METHODS
Sixty-one consecutive patients who had undergone PCNL between October 2006 and June 2007 were prospectively recruited into the study. Preoperative urine cultures and intraoperative stone and pelvic urine cultures were obtained from all patients. Postoperatively, patients were closely monitored for fever and other signs of systemic inflammatory response syndrome.


RESULTS
Of 61 patients, 10 (16.8%) had at least one body temperature recorded at 38 degrees C (group 1), the remaining patients were afebrile (group 2). Fever was associated with a systemic inflammatory response syndrome in one patient (1.6%); in that patient, the antibiotic regimen was altered. There were statistically significantly more positive stone culture results for patients in group 1 than there were for patients in group 2 (5/10 versus 9/51, P < 0.05). There were statistically significantly more positive pelvic urine culture results for patients in group 1 than there were for patients in group 2 (3/10 versus 2/51, P < 0.05). Patients in group 1 also had longer operative times and larger stone burdens than did patients in group 2.


CONCLUSIONS
Intraoperative microbiologic evaluation may be important in postoperative antibiotic selection and should be routinely used.
Gonen
Murat
M
Department of Urology, Baskent University Konya Research and Practice Cente, Konya, Turkey. murat.gonen4@gmail.com
Turan
Hale
H
Ozturk
Bulent
B
Ozkardes
Hakan
H
D015169:Colony Count, Microbial; D003710:Demography; D005334:Fever / Q000209:etiology*; D006801:Humans; D007669:Kidney Calculi / Q000382:microbiology; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects*; D011446:Prospective Studies; D014556:Urine / Q000382:microbiology