To prevent postoperative infectious complications, a urinary tract infection should be either diagnostically excluded or treated prior to ureterorenoscopy (URS). URS is a frequently performed endoscopic surgery for urological stone removal. Although the urinary dipstick test represents a simple and cost-effective method to gain information about the presence of urinary tract infection, the prevailing procedure is the more expensive and more time-consuming method of urine culture. The aim of this retrospective single-center study was to compare two strategies of perioperative prophylaxes prior to URS and to evaluate their impact on postoperative infectious complications: I) Obtaining a urine culture in every patient prior to URS or II) only in case of a positive dipstick test. Therefore, we retrospectively compared 201 patients in two cohorts undergoing URS. In one cohort a urine culture was obtained only in case of a positive dipstick test of midstream urine sample and in the second cohort a urine culture was prepared for every patient regardless of the dipstick's test results. The study's end point was determined as "infectious failure" (IF), if more than one of the following criteria are fulfilled: postoperative fever, elevation of inflammation laboratory values, significant prolongation of hospital stay and readmission within short-notice. Simple and multiple logistic regressions were performed to evaluate the influence of patient characteristics and preoperative urine analysis strategy on the occurrence of IF. Patients with a score of the American Society of Anesthesiologists (ASA) > 2 had a nearly statistically higher risk (p = .09) to develop an IF than healthier patients with an ASA score ≤ 2. Prestenting was determined as a significant predictive factor (p = .04) for a postoperative IF. No difference in patients with or without IF was detected regarding the two preoperative urine analysis strategies. Sensitivity of dipstick test was 87.5% and the negative predictive value was 89.66%. We found that a negative urine dipstick test result obtained prior to URS eliminated the need for urine culturing in predicting postoperative infectious complication. This approach can reduce preoperative preparation-time and costs without affecting postoperative complication outcomes.

中文翻译：

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术前尿培养-是否有必要预防输尿管镜检查后的感染并发症？

为防止术后感染并发症，应在诊断上排除尿路感染或在输尿管镜检查（URS）之前进行治疗。URS是一种经常进行的内窥镜手术，用于去除泌尿系结石。尽管尿液试纸法是获得有关尿路感染存在信息的一种简单且具有成本效益的方法，但普遍的方法是尿液培养的更昂贵，更耗时的方法。这项回顾性单中心研究的目的是比较URS之前围手术期预防的两种策略，并评估其对术后感染并发症的影响：I）在URS之前或每例患者中获取尿培养物； II）仅在以下情况下：量油尺测试阳性。因此，我们回顾性比较了接受URS的两个队列中的201名患者。在一个队列中，仅在对中游尿液样本进行量油尺检测呈阳性的情况下才获得尿培养物，而在第二个队列中，无论量尺的检测结果如何，都为每个患者准备了尿培养物。如果满足以下标准之一以上，则该研究的终点为“感染失败”（IF）：术后发烧，炎症实验室值升高，住院时间显着延长和在短时间内再次入院。进行了简单和多重逻辑回归分析，以评估患者特征和术前尿液分析策略对IF发生的影响。获得美国麻醉医师学会（ASA）评分的患者> 与ASA得分≤2的健康患者相比，2发生IF的风险具有统计学上较高的统计学意义（p = .09）。假装被确定为术后IF的重要预测因素（p = .04）。对于两种术前尿液分析策略，有无IF患者均无差异。量油尺测试的敏感度为87.5％，阴性预测值为89.66％。我们发现，在URS之前获得的尿液试纸阴性结果消除了在预测术后感染并发症时需要进行尿培养的必要性。这种方法可以减少术前准备时间和成本，而不会影响术后并发症的发生。假装被确定为术后中频的重要预测因素（p = .04）。对于两种术前尿液分析策略，有无IF患者均无差异。量油尺测试的敏感度为87.5％，阴性预测值为89.66％。我们发现，在URS之前获得的尿液试纸阴性结果消除了在预测术后感染并发症时需要进行尿培养的必要性。这种方法可以减少术前准备时间和费用，而不会影响术后并发症的发生。假装被确定为术后中频的重要预测因素（p = .04）。对于两种术前尿液分析策略，有无IF患者均未发现差异。量油尺测试的敏感度为87.5％，阴性预测值为89.66％。我们发现，在URS之前获得的尿液试纸阴性结果消除了在预测术后感染并发症时需要进行尿培养的必要性。这种方法可以减少术前准备时间和成本，而不会影响术后并发症的发生。我们发现，在URS之前获得的尿液试纸阴性结果消除了在预测术后感染并发症时需要进行尿培养的必要性。这种方法可以减少术前准备时间和成本，而不会影响术后并发症的发生。我们发现，在URS之前获得的尿液试纸测试结果为阴性，从而消除了在预测术后感染并发症时进行尿培养的必要性。这种方法可以减少术前准备时间和成本，而不会影响术后并发症的发生。