ORIGINAL RESEARCH article
Front. Surg.
Sec. Genitourinary Surgery and Interventions
Risk Factors for Postoperative Febrile Urinary Tract Infection in Patients with Urolithiasis: A Meta-Analysis
Provisionally accepted
- Yangjiang Hospital of Traditional Chinese Medicine, Affiliated with Guangzhou University of Chinese Medicine, Yangjiang, China
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Objective: To identify risk factors for febrile urinary tract infection (FUTI) following surgical intervention for urinary stones. Methods: We systematically searched seven databases (from CNKI to EMBASE) from inception to May 2025 for cohort and case-control studies investigating risk factors for FUTI. Two investigators independently screened studies, extracted data, and assessed quality (Newcastle-Ottawa Scale). Adjusted odds ratio (OR) with 95% confidence interval (CI) were used as effect measures. Meta-analysis was performed using Stata 12.0. Results: 16 studies (n=5,366) revealed FUTI incidence of 17% (95%CI:12.6-21.3%). Ten significant risk factors were identified: (1) General factors: Stone size (OR=1.29, 95%CI:1.09-1.52) and operative duration (OR=1.05, 95%CI:1.01-1.10). (2) Comorbidity: Diabetes (OR=2.18, 95%CI:1.65-2.87), Renal insufficiency (OR=3.19, 95%CI:2.16-4.70). (3) Preoperative: preoperative hydronephrosis (OR=2.33, 95%CI: 1.14-4.76), elevated preoperative procalcitonin (OR=1.08, 95%CI: 1.03-1.13), preoperative pyuria (OR=4.05, 95%CI:1.88-8.74), preoperative bacteriuria (OR=2.45, 95%CI: 2.07-2.90), perinephric fat stranding (OR=5.09, 95% CI:1.71-15.14), and tissue margin sign (OR=2.84, 95%CI:1.91-4.23). Conclusion: Diabetes mellitus, renal insufficiency, preoperative hydronephrosis, elevated procalcitonin, preoperative pyuria, preoperative bacteriuria, perinephric fat stranding, tissue rim sign, operative duration, and stone size are potential independent predictors of FUTI after urinary stone surgery. These findings enable targeted prevention strategies for high-risk urolithiasis patients.
Keywords: Febrile urinary tract infection (fUTI), Meta-analysis, postoperative, Risk factors, Urinary calculi surgery
Received: 20 Dec 2025; Accepted: 09 Feb 2026.
Copyright: © 2026 Mo, Liang and Ruan. 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: Yongtong Ruan
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