Antibacterial prophylaxis of infectious kidney stones after percutaneous nephrolithotripsy
Perepanova T.S., Radzhabov U.A., Golovanov S.A., Merinov D.S., Arustamov L.D.

Institute of urology and interventional radiology named after N.А. Lopatkin, Moscow

Depending on the type of stone, the risk of recurrence is 50-80%, the postoperative prophylaxis reduces this risk to 10-15% (Christian F. et all. 2015). Frequent development of relapses of infectious kidney stones after percutaneous nephrolithotripsy (PNLT), and the revealed difference in uropathogens in urine and kidney stones require the search for the new regimens of antimicrobial prophylaxis of relapses of infectious stones.
The aim of the study was to reduce the number of relapses of infectious stones after PNLT.
Patients and Methods: 190 patients with coral kidney stones after PNLT were included in the study. We determined the efficacy of postoperative antibacterial prophylaxis regimens of infectious kidney stones based on the results of bacteriological examination of the stone (group 1 of patients) or urine (group 2) taken from the pelvis in the course of PNLT on the frequency of relapses of infectious kidney stones after PNLT.
Results: The observation period for patients after PNLT was 6-18 months after the operation. In 43 (22,6%) patients out of 190 there were relapsed stones. The highest frequency of recurrence was observed in 21 patients of the 1st group (36.2%), in the 2nd group in 10 patients (16.9%) and in the 3rd group (antimicrobial treatment was not performed) in 12 patients (16.4%). Differences between groups 1 and 2 were at the statistical trend level (p = 0.032), the differences between groups 1 and 3 were statistically reliable (p = 0.01).
The conclusion: It was revealed that the postoperative antibacterial prophylaxis regimens of infectious kidney stones, based on the results of bacteriological examination of the urine, taken from the pelvis in the course of PNLT, has the advantages over the antimicrobial regime based on the results of bacteriological examination of stones removed during PNLT.

Key words: infectious stones, struvite, relapse of infectious stones, percutaneous nephrolithotripsy, antibacterial prophylaxis of infectious kidney stones. 
For citation: Perepanova T.S., Radzhabov U.A., Golovanov S.A. et al. Antibacterial prophylaxis of infectious kidney stones after percutaneous nephrolithotripsy // RMJ. 2017. № 27. P. 1987–1991.