REVIEW article
Front. Surg.
Sec. Genitourinary Surgery and Interventions
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1603311
This article is part of the Research TopicPrevention and Treatment of Urolithiasis: Innovation and Novel TechniquesView all 14 articles
Risk Factors for Urosepsis Following Ureteroscopic Lithotripsy: A Systematic Review and Meta-Analysis
Provisionally accepted
- 1Chengdu University, Chengdu, China
- 2Department of Urology, People’s Hospital of Deyang City, Deyang, Sichuan Province, China
- 3Department of Proctology, People's Hospital of Deyang City, Deyang, China
- 4Department of Urology, The Affiliated Hospital of Chengdu University, Chengdu, China
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Background: Ureteroscopic lithotripsy (URSL) is the preferred treatment for urinary tract stones, with urosepsis being its most severe postoperative complication. Although previous studies have investigated risk factors for urosepsis after URSL, significant variations exist in reported risk factors and their associated odds ratios (OR), leading to inconsistent findings across studies. This systematic review and meta-analysis investigated the risk factors for urosepsis after URSL, aiming to establish a scientific foundation for early clinical identification and to reduce the incidence and mortality of this complication. Methods: Case-control and cohort studies on factors influencing urosepsis after URSL were systematically retrieved from major public medical databases, including PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Data, and Chinese Science and Technology Journal Database, up to January 31, 2025. Two researchers independently conducted literature screening, data extraction, quality assessment, and meta-analysis using Stata versions 15.1 and 18.0. Results: A total of 26 studies were included in this analysis, comprising 12,394 patients, of whom 861 patients developed urosepsis. The influencing factors for urosepsis included stone size[OR= 3.10,95% CI (1.20,8.00), P=0.002], number of stones (OR=7.59, 95% confidence interval (CI): 3.82,15.08; P<0.001), history of urinary tract infection (OR=5.96, 95% CI: 4.12, 8.60; P<0.001), positive urine culture (OR=4.95, 95% CI: 3.90,6.28; P<0.001), positive urinary nitrite (OR=7.68, 95% CI: 1.03,52.27; P=0.047], C-reactive protein (OR=4.3, 95% CI: 1.06,17.49; P=0.042), diabetes (OR=3.60, 95% CI: 3.11, 4.16; P<0.001), operation time (OR=1.09, 95% CI: 1.07, 1.11; P<0.001), and stent placement (OR=3.71, 95% CI: 1.94, 7.09; P<0.001]. Conclusion: Urosepsis following URSL is associated with a high mortality rate and significantly threatens patient safety and quality of life. Early identification of the factors influencing urosepsis is crucial to reduce its incidence and improve patient outcomes. Registration: The systematic review and meta-analysis have registered in PROSPERO (CRD42025641787).
Keywords: Lithotripsy, Sepsis, Risk factors, Disease prevention and control, Meta-analysis
Received: 31 Mar 2025; Accepted: 06 Jun 2025.
Copyright: © 2025 Dai, Xiang, Liu, Wen, Tan and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Junlian Xiang, Department of Urology, People’s Hospital of Deyang City, Deyang, Sichuan Province, China
Xiaoli Liu, Department of Proctology, People's Hospital of Deyang City, Deyang, China
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