Air-Migration after Ureteral Intervention: A Prospective Case Series

Abstract

Aims: To investigate whether air in the kidney or bladder is only associated with gas-forming infection, or whether it can be observed after endoscopic interventions including ureteral and cystoscopic. If this is the case, what are the parameters that affect the amount of air in the urinary tract? Study Design: A prospective case series study. Place and Duration of Study: Sample: Department of Urology, Kafkas University Faculty of Medicine, between 2013 and 2014. Methodology: One hundred and forty patients who underwent any kind of ureteral intervention including flexible ureteroscopic lithotripsy (FURS-L), semi-rigid ureteroscopic lithotripsy (URS-L), double J stenting alone (JJS), URS-L + JJS, and FURS-L + JJS due to urinary system stones were enrolled. Computed tomography without contrast substance was performed 6 hours after ureteral intervention in order to determine whether there was any air in the urinary tract. Two groups were formed as group 1 and 2: less than 30 min and longer than 30 min of operation time. Results: Air in the kidney was observed in 40% (24/60) of the patients from group 1 and 80% (64/80) of the patients from group 2 (p<0.05). Air in the bladder was found in 53.3% (32/60) of patients in group 1 and 65% (52/80) in group 2 (p>0.05). The mean area of air (mm2) in the kidney for group 1 and group 2 was 6.54±5.56 and 13.59±15.1 (p>0.05). There were no significant relationships between side of the intervention, air in the kidney and bladder, operation time and waist circumference. Conclusion: Air-migration into the kidneys after ureteral insertions can occur, especially when the operation time is longer than 30 min. If fever or urosepsis is established after ureteroscopic interventions, this situation should be taken into account by the urologists before treating these patients for gas-forming infections.