The clinical signifiance of stent culture and intraoperative urine culture in patients with JJ ureteral stents

Objective: The aim of this study was to compare the stent culture and intraoperative urine cultures of patients who had double J (DJ or JJ) ureteral stent inserted for any reason, to determine the antibiogram susceptibilities and to compare the results with the literatüre data. Materials and Methods: The study included 115 patients who developed hydroureteronephrosis (HUN) due to ureteral stricture, ureteral calculi, ureteropelvic junction calculi and who underwent DJ stenting for these reasons between 1 November 2023 and 1 June 2024 in Urology Clinic of Samsun Training and Research Hospital, Samsun University. In patients whose treatment was completed and stenting was planned, DJ stents were removed under sterile conditions in the operating theatre and a urine culture sample was taken from the ureter intraoperatively simultaneously. Approximately 2 cm from the proximal and distal ends of the stents were placed separately in sterile culture tubes. The DJ stent cultures and urine culture tubes were sent to the microbiology laboratory and the samples were studied and antibiogram susceptibility tests were also performed on the culture samples with bacterial growth. A Shapiro-Wilk test, Independent Sample t Test, Mann-Whitney U test, One-Way ANOVA, Kruskal-Wallis test and Chi-square test were used in the statistical evaluation of the data obtained. Results: There was no significant statistical relationship between DJ stent culture growth and patient age, gender, comorbidity, duration of stent stay, and the reason for stent implantation. There was a significant correlation between growth in proximal DJ stent culture and the degree of HUN (p = 0,003). There was a significant correlation between the reasons for DJ stent implantation and the degree of HUN (p = 0,031). The relationship between the reason for DJ stent implantation and the duration of stent stay was found to be insignificant. It was found to be statistically significant that the degree of HUN increased as the comorbidities increased (p = 0,012). The relationship between growth in stent cultures and intraoperative urine cultures was found to be insignificant. The most common microorganisms grown in stent cultures were Enterococci, Candida and Coagulase-Negative-Staphylococci. Conclusion: Bacterial colonisation that yielded in stent culture and urine culture are not compatible with each other. Colonisation in the stent culture predisposes to urinary tract infection but not severe enough to cause sepsis. In appropriate indications, with suitable prophylaxis, DJ stent implantation is safe. Keywords: DJ stent, hydronephrosis, DJ stent culture, urine culture