Retrograde Intrarenal Surgery Low Risk Trial

This study focuses on flexible ureteroscopic lithotripsy, a procedure commonly used to treat kidney stones and stones in the upper part of the ureter. This surgery is popular because it is minimally invasive and considered very safe. However, there is no clear agreement on whether or which antibiotics should be given to patients before the surgery to prevent infections.

Taiwan is one of the regions in the world with a high rate of urinary tract stones, and because of this, it is especially important to ensure that the best practices are followed to prevent infections during and after the surgery. Currently, there are no official guidelines in Taiwan on which antibiotics should be used before flexible ureteroscopic lithotripsy.

This study aims to compare different types of single-dose antibiotics given before the surgery to see if one is more effective than others in preventing infections. By looking at how different antibiotics perform, the study hopes to provide clearer guidance for doctors in choosing the best antibiotic treatment for patients, ultimately improving patient care and reducing the risk of infections after surgery.

Inclusion criteria

• Stone diameter < 3 cm or stone area < 900 mm2
• Preoperative(2 weeks) negative urine culture
• No active symptoms , including fever, dysuria, urinary frequency, urgency)
• Urinalysis WBC < 10/HPF

Exclusion criteria

• Immunocompromised
• Poor control Diabetes mellitus
• Allergy to antibiotics
• Ureteric stents or Foley catheter present
• Ureteric stricture
• Renal or urethral deformity
• Antibiotic treatment for urinary tract infection in the preceding 4 weeks