Metaphylaxis of infectious kidney stones after percutaneous nephrolithotripsy

Depending on stone type, the risk of a recurrence makes 50-80%, when performing postoperative prevention this risk decreases to 10-15%. Frequent development of a relapses of infectious kidney stones after PCNL, uropathogens revealed a difference in the urine and kidney stones need to find new modes of antimicrobial prophylaxis of recurrences of infectious genesis stones. The aim of the study is to reduce number of a recurrence of stones of an infectious genesis after a percutaneous nephrolithotripsy. Materials and methods. The study included 190 patients after PCNL with staghorn kidney stones. Defined efficiency of the regimens of postoperative antibacterial prophylaxis based on the results of a bacteriological research of a stone or urine taken from the pelvis when carrying out PCNL on the frequency of a recurrence of infectious stones of kidneys after PCNL. Patients were divided into three groups. Patients in Group 1 (n = 58) had prophylactic antimicrobial therapy after discharge on the basis of the bacteriological examination of stone analysis, removed during the surgery; the patients in group 2 (n = 59) - on the basis of the bacteriological examination of urine taken from the pelvis into during surgery and patients of group 3 (n = 73) with sterile urine stones had not prophylactic antibiotic therapy. Results. The period of observation after PCNL made 6-18 months. The largest frequency of a recurrence became perceptible at 21 patients of 1 group (36, 2%), in the 2nd group at 10 patients (16, 9%) and in the 3rd group at 12 patients (16, 4%). Differences between 1 and 2 groups were at the level of a statistical tendency (p=0,032), differences between 1 and 3 groups were statistically reliable (p=0, 01). Conclusion. Advantage of a regimen of postoperative antibacterial prophylaxis of a recurrence of stones of the infectious genesis based on results of a bacteriological research of urine of PCNL taken from the pelvis when carrying out in comparison with the antimicrobial regimen based on results of a bacteriological research of the stones withdrawn during PCNL is taped.