Evaluating Antibiotic-Augmented Irrigation in Patients Undergoing Kidney Stone Surgery "Presentation" - Kriselle Madamba
September 14, 2025
At the World Congress of Endourology and Uro-Technology, Kriselle Madamba presented research on antibiotic-augmented irrigation using neomycin and polymyxin B to reduce infectious complications in high-risk percutaneous nephrolithotomy patients. The retrospective matched case-control study of 100 patients showed dramatic reductions in the treatment group: SIRS decreased from 48% to 16%, sepsis was completely eliminated (0% vs 16%), and postoperative UTIs dropped from 34% to 6%. Multivariable analysis confirmed that antibiotic irrigation independently predicted significantly lower postoperative UTI risk.
Biographies:
Kriselle Madamba, Research Student, University of California, Irvine, Orange, CA
Biographies:
Kriselle Madamba, Research Student, University of California, Irvine, Orange, CA
Read the Full Video Transcript
Kriselle Madamba: My name is Kriselle Madamba, and I'm a research student with the Department of Urology at the University of California, Irvine. I'm presenting our work in the following study, titled Antibiotic-Augmented Irrigation Reduces Infectious Complications in High-Risk Patients Undergoing Percutaneous Nephrolithotomy.
Postoperative infection, including UTI and sepsis, remains a significant concern after percutaneous nephrolithotomy, particularly in high-risk patients, such as those with diabetes, recurrent infections, or indwelling tubes. To address this, we investigated the use of antibiotic-augmented irrigation with neomycin and polymyxin B, which offers broad-spectrum gram-negative coverage. We evaluated whether this approach could reduce infectious complications in high-risk PCNL patients.
We conducted a retrospective matched case-control study using a prospectively maintained database with over 600 patients dating from 2020 to 2024. High-risk PCNL patients were matched based on demographics and infection risk factors. The 50 patients in the treatment group received GU irrigation with neomycin and polymyxin B, while the 50 matched control patients received standard saline irrigation. We compared 30-day infectious outcomes between groups and performed multivariable logistic regression to identify independent predictors of postoperative UTI.
We found that patients who received antibiotic irrigation had significantly fewer infectious events compared to controls. SIRS occurred in only 16% of patients in the GU irrigation group, versus 48% in controls. Sepsis was completely eliminated in the treatment group, compared to 16% in controls. Postoperative UTI within 30 days was seen in 6% of patients in the GU irrigation group, compared to 34% in controls. Readmissions for UTI were 0% versus 14%. Multivariable analysis confirmed that antibiotic irrigation independently predicted a significantly lower risk of postoperative UTI with an adjusted odds ratio of 0.11 and a P-value of 0.005.
In conclusion, in high-risk PCNL patients, antibiotic-augmented irrigation was independently associated with significantly fewer postoperative infectious complications and complete elimination of sepsis.
Kriselle Madamba: My name is Kriselle Madamba, and I'm a research student with the Department of Urology at the University of California, Irvine. I'm presenting our work in the following study, titled Antibiotic-Augmented Irrigation Reduces Infectious Complications in High-Risk Patients Undergoing Percutaneous Nephrolithotomy.
Postoperative infection, including UTI and sepsis, remains a significant concern after percutaneous nephrolithotomy, particularly in high-risk patients, such as those with diabetes, recurrent infections, or indwelling tubes. To address this, we investigated the use of antibiotic-augmented irrigation with neomycin and polymyxin B, which offers broad-spectrum gram-negative coverage. We evaluated whether this approach could reduce infectious complications in high-risk PCNL patients.
We conducted a retrospective matched case-control study using a prospectively maintained database with over 600 patients dating from 2020 to 2024. High-risk PCNL patients were matched based on demographics and infection risk factors. The 50 patients in the treatment group received GU irrigation with neomycin and polymyxin B, while the 50 matched control patients received standard saline irrigation. We compared 30-day infectious outcomes between groups and performed multivariable logistic regression to identify independent predictors of postoperative UTI.
We found that patients who received antibiotic irrigation had significantly fewer infectious events compared to controls. SIRS occurred in only 16% of patients in the GU irrigation group, versus 48% in controls. Sepsis was completely eliminated in the treatment group, compared to 16% in controls. Postoperative UTI within 30 days was seen in 6% of patients in the GU irrigation group, compared to 34% in controls. Readmissions for UTI were 0% versus 14%. Multivariable analysis confirmed that antibiotic irrigation independently predicted a significantly lower risk of postoperative UTI with an adjusted odds ratio of 0.11 and a P-value of 0.005.
In conclusion, in high-risk PCNL patients, antibiotic-augmented irrigation was independently associated with significantly fewer postoperative infectious complications and complete elimination of sepsis.