Journal of pediatric urology · 2026
Preoperative renal pelvis urine density predicts postoperative infection after pediatric retrograde intrarenal surgery: A multicenter retrospective cohort study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Ipek Osman Murat, Dincer Erdinc, Sevinc Ahmet Halil, Sevinc Burcu Hanci, Sevinc Medet, Karli Gokce, Horasanli Kaya
Аннотация
INTRODUCTION: This study aimed to investigate the association between preoperative renal pelvis urine density (RPUD) measured on non-contrast computed tomography (CT) and the risk of postoperative infectious complications in pediatric patients undergoing retrograde intrarenal surgery (RIRS).
METHODS: This multicenter retrospective cohort included 78 pediatric patients (aged 2-17 years, median 10) who underwent RIRS for renal stones. Demographic characteristics, stone features, and operative parameters were recorded. Patients were categorized into two groups based on the presence or absence of postoperative infectious complications, defined according to systemic inflammatory response syndrome criteria.
RESULTS: Postoperative infection occurred in 9 patients (11.5%). The groups were similar in age, sex, and laterality, but upper calyceal stone location was more frequent in the infection group (p = 0.013). Stone volume was significantly higher in the infection group [938.3 mm3 (628.3-2387.6) vs. 571.8 mm3 (377.0-1026.3); p = 0.044], whereas stone density showed no difference. RPUD was markedly higher in the infection group [32 HU (23-32) vs. 11 HU (5-17); p < 0.001]. ROC analysis identified 20 HU as the optimal cut-off [AUC = 0.994 (95% CI: 0.980-1.000), sensitivity 100%, specificity 97.1%). Multivariable analysis revealed RPUD as the only independent predictor of infection (OR: 2.144, 95% CI: 1.200-3.831, p = 0.010).
CONCLUSION: Elevated preoperative RPUD is strongly associated with postoperative infectious complications in pediatric RIRS. RPUD measurement on preoperative CT provides a simple, noninvasive, and highly accurate tool for infection risk stratification.
METHODS: This multicenter retrospective cohort included 78 pediatric patients (aged 2-17 years, median 10) who underwent RIRS for renal stones. Demographic characteristics, stone features, and operative parameters were recorded. Patients were categorized into two groups based on the presence or absence of postoperative infectious complications, defined according to systemic inflammatory response syndrome criteria.
RESULTS: Postoperative infection occurred in 9 patients (11.5%). The groups were similar in age, sex, and laterality, but upper calyceal stone location was more frequent in the infection group (p = 0.013). Stone volume was significantly higher in the infection group [938.3 mm3 (628.3-2387.6) vs. 571.8 mm3 (377.0-1026.3); p = 0.044], whereas stone density showed no difference. RPUD was markedly higher in the infection group [32 HU (23-32) vs. 11 HU (5-17); p < 0.001]. ROC analysis identified 20 HU as the optimal cut-off [AUC = 0.994 (95% CI: 0.980-1.000), sensitivity 100%, specificity 97.1%). Multivariable analysis revealed RPUD as the only independent predictor of infection (OR: 2.144, 95% CI: 1.200-3.831, p = 0.010).
CONCLUSION: Elevated preoperative RPUD is strongly associated with postoperative infectious complications in pediatric RIRS. RPUD measurement on preoperative CT provides a simple, noninvasive, and highly accurate tool for infection risk stratification.