Background and Purpose: The exact mechanism of fever and urosepsis after percutaneous procedures
has not been established. This research studied the frequency of fever after percutaneous
nephrolithotomy (PCNL) and the contributing factors.
Methods: In a cross-sectional study, from September 2003 to March 2004, all 217 patients
with nephrolithiasis treated with PCNL at the Labbafinegad Specialized Urology Center were
studied. Data were collected before, during, and after surgery.
Results: The frequency of fever after PCNL was 25.8% (n = 56) although in 62.2% of the
cases (n = 135), no prophylactic antibiotics had been administered. The mean durations of
hospitalization in patients with and without fever were 5.4 ± 2.3 and 3.4 ± 1.7 days, respectively
(p = 0.001). Significant correlations were observed between fever and female sex (p =
0.005), positive urine culture (p = 0.02), and nephrostomy tube insertion (p = 0.041). Other
variables did not prove to be significant. In logistic regression analysis, female sex and
nephrostomy tube insertion were independently related to post-operative fever.
Conclusion: Although a considerable proportion of our patients had not received prophylactic
antibiotics, the rate of fever after PCNL was no higher than is reported in the literature.
Use of only a short course of antibiotics before surgery for staghorn stones did not result in
a higher rate of fever. Female sex created a higher risk for fever, probably because of the
greater propensity to urinary tract infection. The significant relation of a nephrostomy tube
to fever could be attributed to its role as a foreign body or to use in more complicated cases.
