fever and infection following ureteroscopy and retrograde intrarenal surgery: a systematic review

Objective: this study seeks to determine the potential risk factors contributing to fever and infection after ureteroscopy (urs) and retrograde intrarenal surgery (rirs). materials and methods: a systematic literature search was performed in the pubmed, embase, cochrane library, and web of science databases to identify studies evaluating risk factors for infectious complications post-urs and rirs. the search encompassed studies published up to february 12, 2025. odds ratios and mean differences with 95% confidence intervals were utilized to assess the identified risk factors. results: a collection of 14 studies, encompassing a large patient population of 14,382, was analyzed. the strongest indicator of infection was a positive preoperative urine culture. other key risk factors included female gender, diabetes mellitus, and both preoperative and postoperative stent placement. prolonged operative time was also associated with a higher likelihood of infection. however, no significant relationship was found between infection risk and factors such as age or renal insufficiency. conclusion: fever and infection following urs and rirs were strongly associated with female gender, diabetes mellitus, positive preoperative urine culture, ureteral stent insertion, and prolonged surgical duration. additional research is required to confirm these findings and further refine infection prevention strategies.