Yadkar, Mazin A. (2025) COMPARTMENT-SPECIFIC URINARY MICROBIAL PROFILES AND THEIR ASSOCIATION WITH EARLY POSTOPERATIVE SYSTEMIC INFLAMMATION AFTER ENDOUROLOGICAL SURGERY: A PROSPECTIVE OBSERVATIONAL COHORT STUDY. Manuscripts on the Evolution of Medicine and Natural Sciences, 2 (2). ISSN 3064-8785

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Abstract

Systemic inflammation may follow endourological surgery despite a negative preoperative midstream urine (MSU) culture. MSU may not reflect microbial findings in upper urinary tract or on indwelling devices. We compared microbial findings across urinary compartments and examined their association with postoperative systemic inflammatory response syndrome (SIRS). This prospective single-centre cohort included 120 adults undergoing retrograde intrarenal surgery (RIRS, n = 89) or robot-assisted ureteroplasty (n = 31) at Tikrit General Hospital, Iraq, between June 2024 and December 2025. Preoperative MSU, intraoperative renal-pelvic urine, and ureteral stents retrieved on postoperative day 14 ± 2 underwent culture; stents were sonicated for biofilm recovery. The primary outcome was SIRS within 48 hours. All 14 participants with SIRS and 14 matched controls underwent 16S rRNA gene (V3–V4) sequencing. Because stents were sampled after the outcome window, their findings were analysed retrospectively. SIRS occurred in 14/120 participants (11.7%). Stent sonication was positive in 50/120 (41.7%), including 12/14 (85.7%) participants with SIRS and 38/106 (35.8%) without (odds ratio [OR] 10.7, 95% confidence interval [CI] 2.3–50.5; Fisher p < 0.001). Pelvic-urine cultures were positive in 9/14 versus 19/106 (OR 8.2, 95% CI 2.5–27.4), while MSU cultures were positive in 3/14 versus 6/106 (OR 4.5, 95% CI 0.99–20.8). Shannon diversity was highest in stent biofilm (3.42), followed by pelvic urine (2.15) and MSU (1.12). Findings suggest compartment-specific microbial differences and an association between stent positivity and earlier SIRS. Temporal limitations, few events, and outcome-selected sequencing preclude causal or predictive conclusions. Prospective studies with pre-outcome sampling are warranted.

Item Type:	Article
Uncontrolled Keywords:	Urinary Microbiome, Ureteral Stent, Biofilm, Ureteroscopy, Sonication, 16S rRNA Gene Sequencing, Postoperative Inflammation
Subjects:	H Social Sciences
Depositing User:	admin eprints
Date Deposited:	31 Oct 2026 10:43
Last Modified:	31 Oct 2026 10:43
URI:	http://eprints.umsida.ac.id/id/eprint/17336

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