Purpose <p>Variable patterns of perioperative management and postoperative drainage following pyeloplasty are utilized at our institution. We reviewed our patient population and practices to assess risk factors for postoperative urinary tract infection (UTI) following pediatric pyeloplasty.</p> Methods <p>Electronic health records of patients who underwent open or robotic pyeloplasty from 2018 to 2023 were retrospectively reviewed. Demographics, perioperative characteristics, and postoperative UTI within 30 days were evaluated. Postoperative UTI was defined as symptomatic and requiring antibiotic therapy. Patients with concurrent conditions elevating risk for UTI and asymptomatic patients with positive cultures were excluded. Univariate and multivariate statistical analysis were performed.</p> Results <p>295 patients underwent pyeloplasty with median age of 13 months (IQR 3–91). Eleven (4%) patients had febrile UTI within 30 days of surgery. On univariate analysis, female gender (<i>p</i> = 0.007) and UTI history (<i>p</i> = 0.045) were significantly associated with risk for postoperative UTI. On multivariate analysis, only female gender (OR 4.5, 95% CI 1.2–17.3, <i>p</i> = 0.026) remained significantly associated. No other variables, including type of postoperative drainage and nephrostomy tube drainage prior to surgery, were associated with increased risk.</p> Conclusion <p>Female gender and UTI history were significant predictors of postoperative UTI following pediatric pyeloplasty. This knowledge may help inform parents during preoperative counseling.</p>

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Comprehensive assessment of risk factors for postoperative urinary tract infection following pediatric pyeloplasty

  • Nikhil V. Batra,
  • Kate H. Adaniya,
  • Ashorne K. Mahenthiran,
  • Zachary Eardley,
  • Mark P. Cain,
  • Martin Kaefer,
  • Kirstan K. Meldrum,
  • Rosalia Misseri,
  • Richard C. Rink,
  • Joshua D. Roth,
  • Benjamin M. Whittam,
  • Konrad M. Szymanski,
  • Pankaj P. Dangle

摘要

Purpose

Variable patterns of perioperative management and postoperative drainage following pyeloplasty are utilized at our institution. We reviewed our patient population and practices to assess risk factors for postoperative urinary tract infection (UTI) following pediatric pyeloplasty.

Methods

Electronic health records of patients who underwent open or robotic pyeloplasty from 2018 to 2023 were retrospectively reviewed. Demographics, perioperative characteristics, and postoperative UTI within 30 days were evaluated. Postoperative UTI was defined as symptomatic and requiring antibiotic therapy. Patients with concurrent conditions elevating risk for UTI and asymptomatic patients with positive cultures were excluded. Univariate and multivariate statistical analysis were performed.

Results

295 patients underwent pyeloplasty with median age of 13 months (IQR 3–91). Eleven (4%) patients had febrile UTI within 30 days of surgery. On univariate analysis, female gender (p = 0.007) and UTI history (p = 0.045) were significantly associated with risk for postoperative UTI. On multivariate analysis, only female gender (OR 4.5, 95% CI 1.2–17.3, p = 0.026) remained significantly associated. No other variables, including type of postoperative drainage and nephrostomy tube drainage prior to surgery, were associated with increased risk.

Conclusion

Female gender and UTI history were significant predictors of postoperative UTI following pediatric pyeloplasty. This knowledge may help inform parents during preoperative counseling.