PMID- 36505996
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20221221
IS  - 0974-7796 (Print)
IS  - 0974-7834 (Electronic)
IS  - 0974-7796 (Linking)
VI  - 14
IP  - 4
DP  - 2022 Oct-Dec
TI  - Dilute povidone-iodine irrigation during percutaneous nephrolithotomy to reduce 
      postoperative infective complications - Is there any benefit?
PG  - 353-358
LID - 10.4103/ua.ua_111_21 [doi]
AB  - BACKGROUND AND OBJECTIVE: Infectious complications following stone lithotripsy is 
      a significant source of patient morbidity and mortality. Post percutaneous 
      nephrolithotomy fever is reported in 37% of patients undergoing PCNL and sepsis 
      is the most common cause of mortality following PCNL. Thus, there is an urgent 
      need to tackle lithotripsy-associated bacteremia occurring intraoperatively, 
      keeping in mind the threat of emerging global antibiotic resistance. The aim of 
      our study was to study the efficacy of using intermittent 0.35% dilute 
      Povidone-Iodine (PI) irrigation during PCNL in reducing postoperative infection 
      rate. MATERIALS AND METHODS: This is a prospective observational study done in 24 
      patients diagnosed with Staghorn and matrix calculi requiring PCNL. All patients 
      were taken up for the procedure with sterile urine culture or after treating them 
      with culture-specific antibiotic with initial positive urine culture. 
      Intraoperative pelvic urine was sent for culture and sensitivity. 0.35% dilute PI 
      irrigation was used intermittently during the procedure. Patients were monitored 
      and assessed for signs of post-PCNL infection and PI-related side effects. The 
      results were compared with similar group of patients with similar stone 
      characteristics who underwent PCNL before adopting the dilute PI irrigation 
      protocol (non-PI irrigation group). RESULTS: Among 24 patients, 18 patients had 
      partial or complete Staghorn and 6 had matrix calculi. Five patients with 
      Staghorn and three patients with matrix calculi had positive renal pelvic urine 
      culture. In the non-PI irrigation group, 19 patients had Staghorn stones and 5 
      had matrix calculi. Three patients with Staghorn and two patients with matrix 
      calculi had positive renal pelvic urine culture. Three patients (12.5%) had 
      postoperative fever in the dilute PI irrigation group, compared to 11 patients 
      (45.8%) in the non-PI irrigation group. No patient had PI-related complications. 
      CONCLUSION: Our prospective study highlights that the use of 0.35% dilute PI 
      irrigation intermittently during PCNL reduces the postoperative infection rate 
      significantly.
CI  - Copyright: (c) 2022 Urology Annals.
FAU - Kone, Kalyanaram
AU  - Kone K
AD  - Department of Urology, Mahatma Gandhi Medical College, Puducherry, India.
FAU - Mallikarjun, Naveen Thimiri
AU  - Mallikarjun NT
AD  - Department of Urology, Mahatma Gandhi Medical College, Puducherry, India.
FAU - Philipraj, Joseph
AU  - Philipraj J
AD  - Department of Urology, Mahatma Gandhi Medical College, Puducherry, India.
LA  - eng
PT  - Journal Article
DEP - 20220907
PL  - India
TA  - Urol Ann
JT  - Urology annals
JID - 101510823
PMC - PMC9731197
OTO - NOTNLM
OT  - Dilute betadine irrigation
OT  - percutaneous nephrolithotomy
OT  - polyvinylpyrrolidone-iodine
OT  - post percutaneous nephrolithotomy fever
OT  - povidone-iodine
COIS- There are no conflicts of interest.
EDAT- 2022/12/13 06:00
MHDA- 2022/12/13 06:01
PMCR- 2022/10/01
CRDT- 2022/12/12 11:08
PHST- 2021/06/21 00:00 [received]
PHST- 2021/10/27 00:00 [revised]
PHST- 2021/11/23 00:00 [accepted]
PHST- 2022/12/12 11:08 [entrez]
PHST- 2022/12/13 06:00 [pubmed]
PHST- 2022/12/13 06:01 [medline]
PHST- 2022/10/01 00:00 [pmc-release]
AID - UA-14-353 [pii]
AID - 10.4103/ua.ua_111_21 [doi]
PST - ppublish
SO  - Urol Ann. 2022 Oct-Dec;14(4):353-358. doi: 10.4103/ua.ua_111_21. Epub 2022 Sep 7.