%0 Journal Article %1 citeulike:4010768 %A Riad, %D 2009 %J UroToday International Journal %K medicine urology %R 10.3834/uij.1944-5784.2008.12.07 %T Extracorporeal Shock Wave Lithotripsy (ESWL) Versus Percutaneous Nephrolithotomy (PCNL) in the Eradication of Persistent Bacteriuria Associated with Infected Stones. %U http://dx.doi.org/10.3834/uij.1944-5784.2008.12.07 %V 2 %X Introduction: Infected stones function as a sanctuary for organisms that attenuate the effects of antibiotics. Therefore, to treat urinary tract infection associated with urinary calculi, complete extirpation of the stones is necessary. Objective: We compared the incidence of persistent bacteriuria among patients with infected renal stones treated by (ESWL) and who received long-term antibiotics versus those who were treated by (PCNL) with the aim to completely eradicate all stone fragments. Methods: We studied 73 patients with infected stones who presented with recurrent or persistent urinary tract infections (UTI). Urine culture was positive in all patients. We treated 35 patients by ESWL, of whom 23 had stones larger than 2 cm and were provided with fixed double-j stents for drainage and to prevent obstruction (stents were left in for no more than 6 weeks). The other 38 patients were operated upon by PCNL through single (29 patients) or multiple (9 patients) punctures or sessions. Results: Of the 73 patients included in the study, 67 were available for follow-up (32 from the ESWL group, 35 from the PCNL group). Out of the 35 patients treated with PCNL, 32 (91.4\%) were rendered stone-free, and only 2 of the 3 (5.7\%) patients with residual stones showed evidence of persistent bacteriuria. Out of the 32 patients treated with ESWL, 16 (50\%) were stone-free, and 13 of the 16 (40.6\%) with residual stones showed evidence of persistent bacteriuria. A positive relation was found between residual stone fragments and persistent bacteriuria, as all patients in either group who were stone-free were also free of persistent infection. The study also showed that, in the ESWL group, the rate of eradication of stones and persistent infection was much better in cases with stones less than 2 cm (90.9\% vs. 28.6\%). The incidence of residual infected stone fragments was directly related to the degree of hydronephrosis. Conclusion: PCNL is better than ESWL monotherapy in the eradication of persistent bacteriuria associated with infected stones, especially when associated with moderate and marked hydronephrosis, as it has a much better clearance rate of the residual infected stone fragments. Keywords: Persistent bacteriuria, Stones, ESWL, PCNL Correspondence: Mamdouh Roshdy, Urology Department, Theodor Bilharz Research Institute, Giza, Egypt, mohamedaseel@ymail.com

@article{citeulike:4010768, abstract = {Introduction: Infected stones function as a sanctuary for organisms that attenuate the effects of antibiotics. Therefore, to treat urinary tract infection associated with urinary calculi, complete extirpation of the stones is necessary. Objective: We compared the incidence of persistent bacteriuria among patients with infected renal stones treated by (ESWL) and who received long-term antibiotics versus those who were treated by (PCNL) with the aim to completely eradicate all stone fragments. Methods: We studied 73 patients with infected stones who presented with recurrent or persistent urinary tract infections (UTI). Urine culture was positive in all patients. We treated 35 patients by ESWL, of whom 23 had stones larger than 2 cm and were provided with fixed double-j stents for drainage and to prevent obstruction (stents were left in for no more than 6 weeks). The other 38 patients were operated upon by PCNL through single (29 patients) or multiple (9 patients) punctures or sessions. Results: Of the 73 patients included in the study, 67 were available for follow-up (32 from the ESWL group, 35 from the PCNL group). Out of the 35 patients treated with PCNL, 32 (91.4\%) were rendered stone-free, and only 2 of the 3 (5.7\%) patients with residual stones showed evidence of persistent bacteriuria. Out of the 32 patients treated with ESWL, 16 (50\%) were stone-free, and 13 of the 16 (40.6\%) with residual stones showed evidence of persistent bacteriuria. A positive relation was found between residual stone fragments and persistent bacteriuria, as all patients in either group who were stone-free were also free of persistent infection. The study also showed that, in the ESWL group, the rate of eradication of stones and persistent infection was much better in cases with stones less than 2 cm (90.9\% vs. 28.6\%). The incidence of residual infected stone fragments was directly related to the degree of hydronephrosis. Conclusion: PCNL is better than ESWL monotherapy in the eradication of persistent bacteriuria associated with infected stones, especially when associated with moderate and marked hydronephrosis, as it has a much better clearance rate of the residual infected stone fragments. Keywords: Persistent bacteriuria, Stones, ESWL, PCNL Correspondence: Mamdouh Roshdy, Urology Department, Theodor Bilharz Research Institute, Giza, Egypt, mohamedaseel@ymail.com}, added-at = {2009-08-02T17:00:13.000+0200}, author = {Riad}, biburl = {https://www.bibsonomy.org/bibtex/2d1eedddaa3b9891c0a697547809bb8b4/rwst}, citeulike-article-id = {4010768}, citeulike-linkout-0 = {http://www.urotoday.com/3391/urotoday\_international\_journal/stone\_disease/extracorporeal\_shock\_wave\_lithotripsy\_eswl\_versus\_percutaneous\_nephrolithotomy\_pcnl\_in\_the\_eradication\_of\_persistent\_bacteriuria\_associated\_with\_infected\_stones.html}, citeulike-linkout-1 = {http://dx.doi.org/10.3834/uij.1944-5784.2008.12.07}, description = {my bookmarks from citeulike}, doi = {10.3834/uij.1944-5784.2008.12.07}, interhash = {48eaa7c263dd6969d61f5376ac0aa660}, intrahash = {d1eedddaa3b9891c0a697547809bb8b4}, journal = {UroToday International Journal}, keywords = {medicine urology}, month = {February}, posted-at = {2009-02-05 09:45:22}, priority = {2}, timestamp = {2009-08-18T19:24:06.000+0200}, title = {Extracorporeal Shock Wave Lithotripsy (ESWL) Versus Percutaneous Nephrolithotomy (PCNL) in the Eradication of Persistent Bacteriuria Associated with Infected Stones.}, url = {http://dx.doi.org/10.3834/uij.1944-5784.2008.12.07}, volume = 2, year = 2009 }