Extraction Strings for Ureteric Stents: Is There an Increased Risk for Urinary Tract Infections?

Surg Infect (Larchmt). 2017 Nov/Dec;18(8):936-940. doi: 10.1089/sur.2017.165. Epub 2017 Oct 4.

Abstract

Background: To evaluate urinary tract infections associated with placement of ureteric stents, we performed a retrospective study and compared rates between patients with and patients without an extraction string attached to the ureteric stent. Indwelling ureteric stents are routinely removed by cystoscopy. If an extraction string has been connected to the stent at the time of placement, however, the removal can be performed without an invasive procedure. Concerns exist regarding the risk for an unintentional dislocation, increased stent-related discomfort, or an increase of the post-operative urinary tract infection rate.

Methods: All elective transurethral ureteric stent placements performed between November 2011 and December 2012 in our department were included for this investigation. Urinary tract infection was defined according to the Centers for Disease Control and Prevention (CDC)/National Healthcare Safety Network (NHSN) surveillance definition of health-care-associated infections. Patients with an existing urinary tract infection at the time of admission were excluded from the analysis.

Results: A total of 342 patients receiving ureteric stents were evaluated regarding post-operative urinary tract infections. Of these patients, 127 (37.1%) had an extraction string and 215 (62.9%) a stent without a string. The total urinary tract infection rate was 6.4% with no significant difference between the two groups (7.9% vs. 5.6%, p = 0.49).

Conclusion: In the present study, we did not observe an increased rate of post-operative urinary tract infections in patients with an extraction string attached to the ureteral stent. Extraction string is a good option for patients to avoid cystoscopic stent removal.

Keywords: antibiotic prophylaxis; fluoroquinolone; infections; post-operative infection; surgical site infection.

MeSH terms

  • Device Removal / adverse effects
  • Device Removal / instrumentation
  • Device Removal / methods*
  • Female
  • Humans
  • Hydronephrosis / surgery
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Risk Factors
  • Stents* / adverse effects
  • Ureter*
  • Urinary Tract Infections / epidemiology
  • Urinary Tract Infections / etiology*
  • Urolithiasis / surgery