Postoperative systemic inflammatory response syndrome risk in asymptomatic versus symptomatic ureteral stone patients undergoing ureteroscopy: A retrospective comparative study.

ObjectiveTo compare postoperative infection-related characteristics and risk factors for systemic inflammatory response syndrome between asymptomatic and symptomatic ureteral stone patients undergoing ureteroscopy.MethodsThis retrospective cohort study included 475 patients undergoing ureteroscopy for ureteral stones from May 2023 to August 2024. Patients were divided into asymptomatic (n = 85) and symptomatic (n = 390) groups. Clinical characteristics and inflammatory markers were compared, and multivariate logistic regression was used to identify independent risk factors for postoperative systemic inflammatory response syndrome.ResultsThe asymptomatic group had higher stone impaction rates, larger stone volumes, and longer operative time but lower inflammatory markers (all p < 0.05). The incidence of systemic inflammatory response syndrome was lower in the asymptomatic group. In the symptomatic group, independent risk factors for systemic inflammatory response syndrome included sex, urine culture, operative time, C-reactive protein, and systemic immune-inflammation index. In the asymptomatic group, only positive urine culture was identified as a risk factor.ConclusionsAsymptomatic ureteral stones are associated with a lower risk of postoperative systemic inflammatory response syndrome. However, positive urine culture remains a key predictor of postoperative infection and requires careful management.