Abstract / Summary
Background: Infectious complications constitute a significant postoperative concern following ureterorenoscopy (URS) for urinary stone disease. Therefore, identification of associated clinical and procedural factors may improve perioperative risk stratification. This study aims to determine the frequency and associated factors of early infectious complications within 30 days following URS for stone disease at a tertiary care hospital in Karachi, Pakistan. Methodology: A prospective longitudinal study was conducted at Liaquat National Hospital, Karachi from March- July, 2026. A total of 164 patients aged 18–80 years who underwent semi-rigid or flexible URS for stone disease were enrolled through non-probability consecutive sampling. Baseline demographic, clinical, stone-related, and perioperative data were recorded. Early infectious complications were assessed within 30-day follow-up visits. Bivariate analysis and multivariable logistic regression identified independent predictors of infection. Results: The median age of patients was 39 years and 70.1% of participants were male. The early infectious complication rate was 11.0%after 30 days of follow-up. UTI was the most common complication (66.7%), followed by urosepsis (16.7%). On multivariable logistic regression, stone size was the only significant independent predictor of early postoperative infectious complications (aOR = 1.26; 95% CI: 1.01–1.56; p = 0.039), with each additional millimeter increasing infection odds by 26%. Upper ureter stone location showed a clinically meaningful trend (p = 0.064). Conclusion: Early infectious complications occurred in 11.0% of patients within 30 days of URS, with greater stone size independently associated with infection. This highlights the need for enhanced perioperative assessment and postoperative surveillance in patients with larger stones.