Kriselle Madamba: Dear viewers, postoperative infection remains a significant concern after percutaneous nephrolithotomy, particularly in high risk patients such as those with diabetes, recurrent infections, or indwelling catheters. To address this, we investigated the use of antibiotic augmented irrigation with GU irrigant. 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 stating from 2020 to 2024.

High risk patients were matched based on demographics and infection risk factors. The treatment group received GU irrigant containing neomycin and polymyxin B while controls received standard saline irrigation. 30 day infectious outcomes were compared and multi-variable logistic regression was performed to identify independent predictors of postoperative UTI. Postoperative UTI occurred in 6% of the GU irrigant group versus 34% of controls. SIRS occurred in 16% versus 48%, and sepsis was completely eliminated in the treatment group compared to 16% in controls.

Readmissions for UTI were 0% versus 14%, and prolonged hospital stay was 0% versus 20%. Multivariable analysis showed antibiotic irrigation independently reduced UTI risk with an adjusted odds ratio of 0.11. In conclusion, among high risk PCNL patients, antibiotic augmented irrigation was independently associated with significantly fewer postoperative infectious complications and complete elimination of sepsis. Thank you.