Early Stone Manipulation in Urinary Tract Infection Associated with Obstructing Nephrolithiasis
A urinary tract infection (UTI) and sepsis secondary to an obstructing stone are one of the few true urological emergencies. The accepted management of infected ureteral stones includes emergent decompression of the collecting system as well as antibiotic therapy. Despite this, no consensus guidelin...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Case Reports in Urology |
| Online Access: | http://dx.doi.org/10.1155/2018/2303492 |
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| author | Megan L. Swonke Ali M. Mahmoud Elias J. Farran Tamer J. Dafashy Preston S. Kerr Christopher D. Kosarek Joseph Sonstein |
| author_facet | Megan L. Swonke Ali M. Mahmoud Elias J. Farran Tamer J. Dafashy Preston S. Kerr Christopher D. Kosarek Joseph Sonstein |
| author_sort | Megan L. Swonke |
| collection | DOAJ |
| description | A urinary tract infection (UTI) and sepsis secondary to an obstructing stone are one of the few true urological emergencies. The accepted management of infected ureteral stones includes emergent decompression of the collecting system as well as antibiotic therapy. Despite this, no consensus guidelines clarify the optimal time to undergo definitive stone management following decompression. Historically, our institution has performed ureteroscopy with laser lithotripsy (URS-LL) treatment at least 1 to 2 weeks after decompression to allow for clinical improvement and completion of an antibiotic course. In this case series, we retrospectively review four cases in which patients had a documented UTI secondary to an obstructive ureteral stone. The patients underwent urgent decompression and, based on labs and clinical improvement, were subsequently treated with URS-LL. The presented patients received URS-LL within 5 days of decompression and antibiotics. The patients had no sepsis related postoperative complications from the accelerated course of treatment, resulting in discharge within 2 days following URS-LL. We provide a detailed examination of each patient presentation to describe our institution’s experience with treating infected kidney stones within days of urgent decompression in order to question the previous standard of treating an infected kidney stone with a more delayed intervention. |
| format | Article |
| id | doaj-art-caa52c8b56ae4374907f7bcf6e76e762 |
| institution | Kabale University |
| issn | 2090-696X 2090-6978 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Urology |
| spelling | doaj-art-caa52c8b56ae4374907f7bcf6e76e7622025-02-03T01:27:30ZengWileyCase Reports in Urology2090-696X2090-69782018-01-01201810.1155/2018/23034922303492Early Stone Manipulation in Urinary Tract Infection Associated with Obstructing NephrolithiasisMegan L. Swonke0Ali M. Mahmoud1Elias J. Farran2Tamer J. Dafashy3Preston S. Kerr4Christopher D. Kosarek5Joseph Sonstein6Division of Urology, Department of Surgery, University of Texas Medical Branch, Galveston, Texas, USADivision of Urology, Department of Surgery, University of Texas Medical Branch, Galveston, Texas, USADivision of Urology, Department of Surgery, University of Texas Medical Branch, Galveston, Texas, USADivision of Urology, Department of Surgery, University of Texas Medical Branch, Galveston, Texas, USADivision of Urology, Department of Surgery, University of Texas Medical Branch, Galveston, Texas, USADivision of Urology, Department of Surgery, University of Texas Medical Branch, Galveston, Texas, USADivision of Urology, Department of Surgery, University of Texas Medical Branch, Galveston, Texas, USAA urinary tract infection (UTI) and sepsis secondary to an obstructing stone are one of the few true urological emergencies. The accepted management of infected ureteral stones includes emergent decompression of the collecting system as well as antibiotic therapy. Despite this, no consensus guidelines clarify the optimal time to undergo definitive stone management following decompression. Historically, our institution has performed ureteroscopy with laser lithotripsy (URS-LL) treatment at least 1 to 2 weeks after decompression to allow for clinical improvement and completion of an antibiotic course. In this case series, we retrospectively review four cases in which patients had a documented UTI secondary to an obstructive ureteral stone. The patients underwent urgent decompression and, based on labs and clinical improvement, were subsequently treated with URS-LL. The presented patients received URS-LL within 5 days of decompression and antibiotics. The patients had no sepsis related postoperative complications from the accelerated course of treatment, resulting in discharge within 2 days following URS-LL. We provide a detailed examination of each patient presentation to describe our institution’s experience with treating infected kidney stones within days of urgent decompression in order to question the previous standard of treating an infected kidney stone with a more delayed intervention.http://dx.doi.org/10.1155/2018/2303492 |
| spellingShingle | Megan L. Swonke Ali M. Mahmoud Elias J. Farran Tamer J. Dafashy Preston S. Kerr Christopher D. Kosarek Joseph Sonstein Early Stone Manipulation in Urinary Tract Infection Associated with Obstructing Nephrolithiasis Case Reports in Urology |
| title | Early Stone Manipulation in Urinary Tract Infection Associated with Obstructing Nephrolithiasis |
| title_full | Early Stone Manipulation in Urinary Tract Infection Associated with Obstructing Nephrolithiasis |
| title_fullStr | Early Stone Manipulation in Urinary Tract Infection Associated with Obstructing Nephrolithiasis |
| title_full_unstemmed | Early Stone Manipulation in Urinary Tract Infection Associated with Obstructing Nephrolithiasis |
| title_short | Early Stone Manipulation in Urinary Tract Infection Associated with Obstructing Nephrolithiasis |
| title_sort | early stone manipulation in urinary tract infection associated with obstructing nephrolithiasis |
| url | http://dx.doi.org/10.1155/2018/2303492 |
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