Risk Factors and Clinical Implications of Double-J Ureteral Stent Bacterial Colonization

This prospective observational cohort study will enroll adult patients undergoing temporary Double-J ureteral stent insertion at Al-Azhar University hospitals in Cairo, Egypt. Participants will be followed from stent insertion until removal. Baseline demographic, clinical, and laboratory data will be collected, together with stent-related variables such as stent side, size, material, and indwelling time. Midstream urine culture will be obtained when feasible before insertion and again at removal, and the stent will be cultured under sterile conditions at removal.

The primary outcome is bacterial colonization of the Double-J stent, defined as positive growth on stent culture at removal. Secondary outcomes include positive urine culture, febrile urinary tract infection, concordance between urine and stent cultures, antimicrobial resistance patterns, stent-related symptom burden, and need for hospitalization or additional treatment. Risk factors for colonization will be analyzed using multivariable logistic regression.

Inclusion criteria

• Age 18 years or older.
• Temporary Double-J stent insertion.
• Standard urological indication.
• Planned stent removal during follow-up.
• Ability to attend follow-up and provide specimens.
• Written informed consent.

Exclusion criteria

• Active urosepsis at insertion.
• Permanent or intended long-term stenting.
• Concomitant nephrostomy tube or urinary diversion.
• Severe immunosuppression or neutropenia.
• Incomplete baseline data.
• Loss to follow-up or failure to retrieve the stent.
• Refusal to participate.