Renal pelvis urine density as a predictor of infectious complications after semi-rigid ureterorenoscopy for ureteral stone treatment

Authors

  • Oguzhan Yildiz Haseki Training and Research Hospital, Istanbul, Turkey
  • Ufuk Caglar Haseki Training and Research Hospital, Istanbul, Turkey
  • Huseyin Burak Yazili Haseki Training and Research Hospital, Istanbul, Turkey
  • Muhammet Rasit Tutal Haseki Training and Research Hospital, Istanbul, Turkey
  • Arda Meric Haseki Training and Research Hospital, Istanbul, Turkey
  • Omer Sarilar Haseki Training and Research Hospital, Istanbul, Turkey
  • Faruk Ozgor Haseki Training and Research Hospital, Istanbul, Turkey

DOI:

https://doi.org/10.5489/cuaj.9273

Keywords:

Complications, Ureter stone, Renal pelvis urine density, URS

Abstract

INTRODUCTION: This study aimed to investigate whether renal pelvis urine density (RPUD) serves as a reliable predictor of postoperative infectious complications in patients undergoing semi-rigid ureterorenoscopy (URS) for ureteral stone treatment.

METHODS: We retrospectively reviewed 1104 patients who underwent semi-rigid URS for ureteral stones. Patients were divided into two groups based on whether they developed postoperative infections within one month (n=64) or not (n=1040). Demographic variables (age, sex, body mass index), comorbidities, stone characteristics (location, size, density), and operative parameters (operation time, stent/catheter placement) were recorded. RPUD was measured in Hounsfield units (HU) on preoperative imaging.

RESULTS: Of the 1104 patients, 64 (5.8%) developed postoperative infections. The median RPUD was significantly higher in the infectious group (10 [5–17] HU) compared to the noninfectious group (4 [2–6] HU; p=0.001). On multivariate analysis, sex (odds ratio [OR] 4.001, 95% confidence interval [CI] 2.231–7.174, p=0.001), body mass index (OR 0.920, 95% CI 0.860–0.984, p=0.015), operative time (OR 0.963, 95% CI 0.932–0.996, p=0.028), and RPUD (OR 0.809, 95% CI 0.771–0.849, p=0.001) were independent predictors of postoperative infection. The area under the curve was 0.784 (95% CI 0.711–0.857, p<0.001), demonstrating good discriminative ability. When a cutoff value of 6.35 was applied, the sensitivity and specificity were 71.9% and 76.9%, respectively, for predicting postoperative infections.

CONCLUSIONS: Higher RPUD is significantly associated with an increased risk of infectious complications following semi-rigid URS for ureteral stones. Incorporating RPUD into preoperative assessments may help identify high-risk patients and optimize perioperative management to reduce infection-related morbidity.

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Published

2025-09-23

How to Cite

Yildiz, O., Caglar, U., Yazili, H. B., Tutal, M. R., Meric, A., Sarilar, O., & Ozgor, F. (2025). Renal pelvis urine density as a predictor of infectious complications after semi-rigid ureterorenoscopy for ureteral stone treatment. Canadian Urological Association Journal, 20(1), E50–5. https://doi.org/10.5489/cuaj.9273

Issue

Vol. 20 No. 1 (2026): CUAJ January

Section

Original Research

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