Risk factors for urological infection after laparoscopic ureterolithotomy.

Abstract

Objective: To investigate and analyze the risk factors of urological infection after laparoscopic ureterolithotomy.

Methods: In this retrospective study, 312 patients who underwent laparoscopic ureterolithotomy were included. Among them, 164 patients developed urological infection post-surgery. Key risk factors for urological infection were identified using univariate and multivariate regression analyses. A clinical nomogram was constructed based on these factors, and its predictive accuracy was assessed using the concordance index (C-index) and calibration plot.

Results: Univariate and multivariate regression analyses identified age >75 years old (95% CI 0.007-0.340; P=0.002), operation time ≥60 min (95% CI 4.506-90.528; P<0.001), postoperative catheter indwelling time >7 days (95% CI 2.315-6.060; P<0.001), diabetes mellitus (95% CI 4.051-24.682; P<0.001), and hospital stay >7 days (95% CI 1.600-37.144; P=0.011) as independent risk factors for urological infection after laparoscopic ureterolithotomy. Those factors were used to construct a predictive nomogram. The regression model was established as: logit (P) = -6.820 + 0.216 * age + 0.312 * operation time + 0.661 * postoperative indwelling catheter time + 0.433 * diabetes mellitus + 0.671 * hospital stay. The calibration curve demonstrated excellent accuracy of the nomogram model. Decision curve analysis indicated that the model is clinically applicable for threshold probabilities ranging from 20% to 75%.

Conclusions: Age >75 years old, operation time ≥60 min, postoperative indwelling catheter time >7 days, diabetes mellitus, and hospital stay >7 days are independent risk factors for urological infection after laparoscopic ureterolithotomy. Effective monitoring, management, and predictive measures for high-risk patients should significantly reduce the incidence of urological infection.