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Abstract：
BACKGROUND: Patients with urosepsis associated with upper urinary tract stones require further stone management after emergency drainage.
OBJECTIVE: To evaluate the safety and efficacy of elective flexible ureteroscopic lithotripsy (F-URSL) for upper urinary tract stones in patients with prior urosepsis who have undergone emergency drainage using retrograde ureteral stent(RUS) or percutaneous nephrostomy (PCN).
METHODS: Between January 2017 and December 2021, clinical data were collected for 102 patients who underwent elective F-URSL following emergency drainage for urosepsis caused by upper ureteral or renal stones. The patients were categorized into two groups based on the drainage method used: the RUS group and the PCN group. The collected data included patient demographics, stone parameters, infection recovery after emergency drainage, and clinical outcomes post F-URSL. Subsequently, the data underwent statistical analysis.
RESULTS: A total of 102 patients were included in the statistical analysis, with 58 (56.86%) in the RUS group and 44 (43.14%) in the PCN group. Among the patients, 84 (82.35%) were female and 18 (17.65%) were male, with an average age of 59.36 years. Positive urine cultures were observed in 71 (69.61%) patients. Successful drainage was achieved in all patients in both groups, and there were no significant differences in the time required for normalization of white blood cell count (WBC) and body temperature following drainage. Additionally, all patients underwent F-URSL successfully, and no statistically significant differences were observed between the two groups in terms of operative time, stone-free rates, postoperative fever, and postoperative hospital stay.
CONCLUSIONS: Both RUS and PCN have been established as effective approaches for managing urosepsis caused by upper urinary tract stones. Furthermore, the impact of these two drainage methods on the subsequent management of stones through elective F-URSL has shown consistent outcomes.
OBJECTIVE: To evaluate the safety and efficacy of elective flexible ureteroscopic lithotripsy (F-URSL) for upper urinary tract stones in patients with prior urosepsis who have undergone emergency drainage using retrograde ureteral stent(RUS) or percutaneous nephrostomy (PCN).
METHODS: Between January 2017 and December 2021, clinical data were collected for 102 patients who underwent elective F-URSL following emergency drainage for urosepsis caused by upper ureteral or renal stones. The patients were categorized into two groups based on the drainage method used: the RUS group and the PCN group. The collected data included patient demographics, stone parameters, infection recovery after emergency drainage, and clinical outcomes post F-URSL. Subsequently, the data underwent statistical analysis.
RESULTS: A total of 102 patients were included in the statistical analysis, with 58 (56.86%) in the RUS group and 44 (43.14%) in the PCN group. Among the patients, 84 (82.35%) were female and 18 (17.65%) were male, with an average age of 59.36 years. Positive urine cultures were observed in 71 (69.61%) patients. Successful drainage was achieved in all patients in both groups, and there were no significant differences in the time required for normalization of white blood cell count (WBC) and body temperature following drainage. Additionally, all patients underwent F-URSL successfully, and no statistically significant differences were observed between the two groups in terms of operative time, stone-free rates, postoperative fever, and postoperative hospital stay.
CONCLUSIONS: Both RUS and PCN have been established as effective approaches for managing urosepsis caused by upper urinary tract stones. Furthermore, the impact of these two drainage methods on the subsequent management of stones through elective F-URSL has shown consistent outcomes.
摘要：
背景：与上尿路结石相关的尿脓毒血症患者在紧急引流后需要进一步的结石处理。
目的：评估选择性输尿管软镜碎石术（F-URSL）治疗上尿路结石的安全性和有效性。
方法：在2017年1月至2021年12月期间，收集102例患者的临床资料，这些患者因输尿管上段或肾结石引起的尿脓毒血症在急诊引流后接受了择期F-URSL。根据使用的引流方法将患者分为两组：RUS组和PCN组。收集的数据包括患者的人口统计，石材参数,紧急引流后感染恢复，和F-URSL后的临床结果。随后，对数据进行统计分析.
结果：共102例患者纳入统计分析，RUS组58（56.86%），PCN组44（43.14%）。在患者中,84（82.35%）为女性，18（17.65%）为男性，平均年龄为59.36岁。71例（69.61%）患者尿培养阳性。两组患者均成功引流,引流后白细胞计数（WBC）和体温正常化所需的时间没有显着差异。此外,所有患者均成功接受F-URSL，两组手术时间差异无统计学意义,无石率，术后发热,术后住院时间。
结论：RUS和PCN均已被确定为治疗由上尿路结石引起的尿脓毒血症的有效方法。此外，这两种引流方法对随后通过选择性F-URSL处理结石的影响显示出一致的结果。
目的：评估选择性输尿管软镜碎石术（F-URSL）治疗上尿路结石的安全性和有效性。
方法：在2017年1月至2021年12月期间，收集102例患者的临床资料，这些患者因输尿管上段或肾结石引起的尿脓毒血症在急诊引流后接受了择期F-URSL。根据使用的引流方法将患者分为两组：RUS组和PCN组。收集的数据包括患者的人口统计，石材参数,紧急引流后感染恢复，和F-URSL后的临床结果。随后，对数据进行统计分析.
结果：共102例患者纳入统计分析，RUS组58（56.86%），PCN组44（43.14%）。在患者中,84（82.35%）为女性，18（17.65%）为男性，平均年龄为59.36岁。71例（69.61%）患者尿培养阳性。两组患者均成功引流,引流后白细胞计数（WBC）和体温正常化所需的时间没有显着差异。此外,所有患者均成功接受F-URSL，两组手术时间差异无统计学意义,无石率，术后发热,术后住院时间。
结论：RUS和PCN均已被确定为治疗由上尿路结石引起的尿脓毒血症的有效方法。此外，这两种引流方法对随后通过选择性F-URSL处理结石的影响显示出一致的结果。
