{"paper_id":"39db4eaf-e209-45a3-9fcf-a5c4770921aa","body_text":"Intrarenal pressure monitoring in retrograde intrarenal surgery for high- infectious risk populations | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Intrarenal pressure monitoring in retrograde intrarenal surgery for high- infectious risk populations Shuzo Hamamoto, Takaaki Inoue, Daisuke Kudo, Toshimitsu Matsuoka, and 7 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8790860/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 9 You are reading this latest preprint version Abstract Purpose To evaluate whether real-time intrarenal pressure (IRP) monitoring using the LithoVue™ Elite (LVE) ureteroscope reduces infectious complications after retrograde intrarenal surgery (RIRS) in patients with positive urine cultures. Methods This multicenter, single-arm, prospective cohort study (August 2023–October 2024) included patients with upper urinary tract calculi and positive preoperative urine cultures who underwent RIRS with real-time IRP monitoring via the LVE. Irrigation was adjusted to maintain IRPs below 30 mmHg. The primary endpoint was postoperative fever ≥ 38°C. Secondary endpoints included systemic inflammatory response syndrome (SIRS), stone-free rates, ipsilateral flank pain scores, and complications. Results Of 148 eligible patients, 104 were enrolled. The median operative time and artificial intelligence-corrected IRP were 50 min (interquartile range: 36.8–80.0) and 13.3 mmHg (10.4–19.1), respectively. Postoperative fever occurred in 7.7% of patients, SIRS in 3.8%, and no septic shock was observed. Patients who developed postoperative fever were older (p = 0.019) and had longer preoperative ureteral stent indwelling times (p = 0.015). Univariate linear regression analysis demonstrated that higher body mass index (BMI), irrigation method, and ureteral access sheath tip location were significantly associated with higher intraoperative IRP (all p ≤ 0.005). Higher postoperative white blood cell counts and ipsilateral flank pain scores were also associated with elevated IRP (p = 0.010 and p = 0.032, respectively). In multivariate linear regression analysis, higher BMI and manual irrigation remained independent increased intraoperative IRP predictors (p = 0.042 and p = 0.009, respectively). Conclusion Real-time IRP monitoring using the LVE ureteroscope maintained low intrarenal pressures during RIRS and was associated with substantially less postoperative fever than previously reported in high-risk patients. These findings support incorporating IRP monitoring into RIRS protocols to reduce infectious complications in patients with positive urine cultures. retrograde intrarenal surgery intrarenal pressure postoperative infectious complications sepsis LithoVue™ Elite positive urinary culture Introduction Urolithiasis is a common urinary tract disorder with a reported prevalence of 1–20% [ 1 ]. The widespread adoption of retrograde intrarenal surgery (RIRS) has been driven by advances in endoscopic miniaturisation, single-use digital ureteroscopes, and improved laser lithotripters [ 2 – 5 ]. Despite these developments, postoperative infectious complications remain a clinical concern [ 6 , 7 ]. Postoperative fever occurs in 2.8–7.5% of patients after RIRS [ 7 ] and may reach 16% in those with positive preoperative urine cultures despite appropriate antibiotic therapy [ 8 ]. Risk factors include both patient characteristics and intraoperative factors, such as positive urine cultures, prolonged ureteral stent dwelling time, longer operative duration, and elevated intrarenal pressure (IRP) [ 7 , 9 – 11 ]. IRP is determined by irrigation inflow and outflow, yet its intraoperative quantification has been difficult. The LithoVue™ Elite (LVE) ureteroscope enables continuous real-time IRP monitoring during surgery [ 12 ]. However, clinical evidence demonstrating its effectiveness in reducing infectious complications remains limited. We therefore evaluated whether IRP-guided RIRS using the LVE reduces postoperative infectious events in patients at high infectious risk. Patients and Methods Study design and participants This prospective, single-arm multicentre cohort study was conducted at five centres in Japan between August 2023 and October 2024. The protocol was approved by the Nagoya City University Certified Research Review Board (No. 60-22-0103), registered with UMIN (000059022), and performed in accordance with the Declaration of Helsinki. Written informed consent was obtained from all participants. Eligible patients were aged > 20 years, had upper urinary tract calculi requiring RIRS, and had positive preoperative urine cultures. Exclusion criteria included pregnancy, active pyelonephritis or malignancy, recent RIRS within 3 months, nephrostomy tube placement, anaesthetic contraindications, inability to insert a ≥ 10 Fr ureteral access sheath (UAS), or technical failure of IRP measurement. Surgical technique Antibiotics were administered according to culture sensitivity at the surgeon’s discretion. All procedures were performed using the LVE ureteroscope under general or spinal anaesthesia. UAS size (10/12, 11/13, or 12/14 Fr) was selected after rigid ureteroscopic assessment. Stones were fragmented using a holmium:YAG laser. Irrigation modality (automatic or manual) was chosen by the surgeon, and flow was adjusted using real-time monitoring to maintain IRP < 30 mmHg; renal pelvic aspiration was performed when necessary. A ureteral stent was placed at the end of the procedure and removed within 2 weeks. Data collection The primary outcome was postoperative fever (≥ 38°C) until discharge. Secondary outcomes included systemic inflammatory response syndrome (SIRS) score ≥ 2, postoperative C-reactive protein (CRP), stone-free rate (SFR), operative time, intraoperative IRP, ipsilateral flank pain score on postoperative day 1, and complications according to the Clavien–Dindo classification. Stone-free status was defined as residual fragments ≤ 2 mm on CT 1 month postoperatively. IRP data were corrected postoperatively using our previously reported artificial intelligence (AI)–based artefact correction model [ 13 ]. Pelvicalyceal anatomy was classified intraoperatively as Type I or II using the Takazawa classification [ 14 ]. UAS outflow was graded subjectively as poor, fair, or good. Statistical analyses Sample size was estimated using the two-sided 95% confidence interval for postoperative fever. Assuming a 4% fever rate, 90 patients were required; allowing for dropouts, the target enrolment was 100. Statistical analyses were performed using EZR for R (v4.4.1). Categorical variables were compared using Fisher’s exact test and continuous variables using the Mann–Whitney U test. Factors associated with elevated IRP were assessed by univariate and multivariate linear regression. A p-value < 0.05 was considered significant. Results Overall, 148 eligible patients were consecutively recruited, and 104 were ultimately enrolled in the study. The exclusion reasons were as follows: 27 patients had tight ureters that precluded the insertion of adequately sized UASs, eight in whom the IRP could not be measured due to mechanical error, seven in whom the LVE was not applied at the surgeon’s discretion, and two in whom the procedure was terminated. Primary and secondary outcomes Baseline characteristics and surgical outcomes are summarised in Table 1 . The specific bacteria identified in the urine cultures are listed in Supplementary Table 1. Postoperative fever occurred in 7.7% of patients and SIRS in 3.8%, with no cases of septic shock. The median operative time was 50 min, and the SFR was 80.8%. Grade I and II complications occurred in 2.9% and 4.8%, respectively. Table 1 Patient characteristics and surgical outcomes Age (years), median [IQR] 67.0 [56.8–74.3] Sex: female, n (%) 67 (64.4) BMI (kg/m 2 ), median [IQR] 23.8 [21.3–27.7] ECOG PS, n (%) 0 51 (49.0) 1 40 (38.5) 2 7 (6.7) 3 5 (3.8) 4 1 (1.0) Comorbidity and past history, n (%) HT 50 (48.1) HL 20 (19.2) DM 22 (21.2) CKD 39 (37.5) Febrile UTI 41 (39.4) Preoperative DJ insertion, n (%) 83(79.8) Stone laterality: right, n (%) 44 (42.3) Stone location, n (%) Renal 44 (42.3) Proximal ureter 46 (44.2) Middle ureter 11 (10.6) Distal ureter 3 (2.9) Stone number, median [IQR] 1.0 [1.0–2.0] Stone area (mm 2 ), median [IQR] 63.5 [33.2–117.1] Stone volume (mm 3 ), median [IQR] 293.7 [117.5–723.2] CT value, median [IQR] 1177.0 [854.0–1453.0] Surgery time (minutes), median [IQR] 50.0 [36.8–80.0] Maximum IRP (mmHg), median [IQR] 43.0 [31.0–75.0] Mean IRP (mmHg), median [IQR] 13.3 [10.4–19.1] Duration with > 20mmHg IRP (seconds), median [IQR] 130.7 [15.7–418.9] Duration with > 30mmHg IRP (seconds), median [IQR] 21.1 [0.6–157.9] Duration with > 40mmHg IRP (seconds), median [IQR] 0.8 [0.0–64.0] Clavien–Dindo grade, n (%) 0 96 (92.3) I 3 (2.9) II 5 (4.8) Postoperative fever, n (%) 8 (7.7) SIRS score, n (%) 0–1 100 (96.2) 2–4 4 (3.8) Septic shock, n (%) 0 (0.0) Stone free status (mm), n (%) <2 84 (80.8) 2.1–4 6 (5.8) >4 14 (13.4) IQR, interquartile range; BMI, body mass index; ECOG PS, Eastern Cooperative Oncology Group performance status; HT, hypertension; HL, hyperlipidaemia; DM, diabetes mellitus; CKD, chronic kidney disease; UTI, urinary tract infection; DJ, double-J; IRP, intrarenal pressure; SIRS, systemic inflammatory response syndrome; CRP, C-reactive protein. Risk factors for postoperative fever Detailed variables were compared between the afebrile and febrile groups (Table 2 ). The median age in the febrile group was significantly higher than in the afebrile group (p = 0.019). The preoperative ureteral stent indwelling time (USIT) was significantly longer in the febrile group than in the afebrile group (p = 0.015). Regarding pyelocalyceal anatomy, the febrile group had more divided pelves (Type 2 classification) than the afebrile group; however, this difference was not statistically significant (p = 0.051). Median postoperative CRP levels and WBC counts were also significantly higher in the febrile group than in the afebrile group (p < 0.001 and p = 0.002, respectively). The median length of hospital stay was also significantly longer in the febrile group (p < 0.001). In contrast, the maximum IRP, mean IRP, and the duration of IRPs > 30 mmHg did not differ significantly between the afebrile and febrile groups. Table 2 Factors associated with postoperative fever after RIRS for high-infectious-risk patients Afebrile group (96) Febrile group (8) p-value Age (years), median [IQR] 66.5 [56.0–74.0] 76.0 [72.0–81.3] 0.019 Sex: female, n (%) 60 (62.5) 7 (87.5) 0.254 BMI (kg/m 2 ), median [IQR] 23.8 [21.3–27.0] 26.0 [21.2–29.6] 0.634 ECOG PS, n (%) 0.119 0 49 (51.0) 2 (25.0) 1 37 (38.5) 3 (37.5) 2 5 (5.2) 2 (25.0) 3 4 (4.2) 1 (12.5) 4 1 (1.0) 0 (0.0) Comorbidity & Past history, n (%) DM 19 (19.8) 3 (37.5) 0.361 CKD 34 (35.4) 5 (62.5) 0.148 Febrile UTI 36 (37.5) 5 (62.5) 0.259 Duration of antibiotic therapy (days), median [IQR] 5.0 [0.0–11.0] 5.0 [2.0–7.0] 0.834 Preoperative DJ insertion, n (%) 75 (78.1) 8 (100.0) 0.354 Preoperative DJ indwell time (days), median [IQR] 15.5 [7.0–28.0] 67.0 [30.5–90.3] 0.015 Preoperative CRP (mg/dL), median [IQR] 0.17 [0.05–0.50] 0.13 [0.07–0.30] 0.875 Preoperative WBC (count/µL), median [IQR] 6060 [4875–7420] 6785 [ 5027–7192[ 0.845 Stone area (mm 3 ), median [IQR] 293.5 [124.3–664.3] 639.4 [102.4–1013.6] 0.506 Pelvicalyceal anatomy, n (%) 0.051 Type 1 79 (82.3) 4 (50.0) Type 2 (Divided pelvis) 17 (17.7) 4 (50.0) Irrigation method, n (%) Manual irrigation 36 (37.5) 2 (25.0) 0.707 Automatic irrigation 60 (62.5) 6 (75.0) UAS size, n (%) 1.000 10/12F 24 (25.5) 2 (28.6) 11/13F 49 (52.1) 4 (57.1) 12/14F 21 (22.3) 1 (14.3) UAS Tip location, n (%) 1.000 Renal Pelvis 1 (1.1) 0 (0.0) Ureteropelvic junction 28 (30.1) 3 (37.5) Proximal ureter 58 (62.4) 5 (62.5) Middle ureter 6 (6.5) 0 (0.0) UAS outflow, n (%) 0.404 Poor 21 (22.3) 2 (25.0) Fair 28 (29.8) 4 (50.0) Good 45 (47.9) 2 (25.0) Surgery time (minutes), median [IQR] 49.0 [36.0–80.0] 62.5 [47.5–70.3] 0.383 Postoperative CRP (mg/dL), median [IQR] 0.32 [0.14–0.90] 6.62 [4.14–8.99] < 0.001 Postoperative WBC (count/µL), median [IQR] 6780 [5502–8347] 13160 [7165–19062] 0.002 Hospital stay (days), median [IQR] 2.00 [2.00–2.00] 9.00 [6.50–10.00] < 0.001 Maximum IRP (mmHg), median [IQR] 43.0 [31.0–75.0] 37.00 [29.5–77.3] 0.729 Mean IRP (mmHg), median [IQR] 13.3 [10.5–19.1] 15.7 [9.7–22.1] 0.719 Duration with > 30 mmHg IRP (seconds), median [IQR] 21.1 [0.6–151.6] 63.8 [1.7–292.8] 0.722 IQR, interquartile range; BMI, body mass index; ECOG PS, Eastern Cooperative Oncology Group performance status; DM, diabetes mellitus; CKD, chronic kidney disease; UTI, urinary tract infection; UAS, ureteral access sheath; DJ, double-J; CRP, C-reactive protein; WBC, white blood cell; IRP, intrarenal pressure. IRP monitoring and elevation risk during RIRS All IRP values presented in this study were AI-adjusted. The maximum IRP was 43.0 (IQR: 31.0–75.0) mmHg, and the mean IRP was 13.3 (IQR: 10.4–19.1) mmHg. The median durations during which the IRP exceeded 20, 30, and 40 mmHg were 130.7, 21.1, and 0.8 seconds, respectively. Factors associated with elevated IRPs during RIRS are shown in Table 3 . Univariate linear regression analysis revealed that higher BMI, irrigation method, and UAS tip location were significantly associated with higher IRP (p < 0.001, p < 0.001, and p = 0.005, respectively). Automatic irrigation was associated with lower IRPs. In addition, UAS tip placement closer to the renal pelvis was associated with lower IRPs. Regarding surgical outcomes, higher postoperative WBC counts and ipsilateral flank pain scores were associated with elevated IRPs (p = 0.010 and 0.032, respectively). In the multivariate linear regression model including patient characteristics and surgical factors (excluding surgical outcomes), higher BMI and manual irrigation were identified as independent predictors of higher intraoperative IRPs (p = 0.042 and 0.009, respectively). Table 3 Factors associated with elevated intrarenal pressure during RIRS Univariate Multivariate Beta SE p-value Beta SE p-value Patients and stone characteristics Age -0.05 0.07 0.424 Sex 1.63 1.92 0.394 BMI 0.04 0.01 < 0.001 0.03 0.02 0.042 HT -0.31 1.85 0.868 HL 2.95 2.35 0.212 DM -4.24 2.17 0.053 -4.09 2.07 0.051 CKD -0.10 1.91 0.958 Preoperative CRP -0.20 0.23 0.381 Preoperative WBC -0.001 -0.001 0.240 Preoperative DJ insertion -3.97 2.24 0.081 0.00 2.37 0.713 Preoperative DJ indwell time -0.04 0.03 0.092 Stone laterality 0.54 1.86 0.772 Stone location (Kidney vs Ureter) -0.15 1.86 0.932 Stone volume 0.001 0.001 0.505 Pelvicalyceal anatomy (Type 1 vs Type 2) 2.02 2.31 0.344 Surgical factors Irrigation method (Manual vs Automatic) -7.08 1.77 < 0.001 -5.50 2.09 0.009 UAS size 10/12F (Reference) 11/13F 1.77 2.22 0.428 12/14F 3.06 2.69 0.258 UAS tip location (Kidney vs Ureter) 4.35 1.54 0.005 1.23 1.68 0.466 UAS outflow Good (Reference) (Reference) Fair 1.64 2.13 0.440 1.41 2.10 0.502 Poor 4.04 2.34 0.088 1.78 2.37 0.453 Surgical outcomes Postoperative fever (≥ 38°C) 4.59 3.40 0.181 Postoperative CRP 0.75 0.44 0.088 Postoperative WBC 0.001 0.001 0.010 Ipsilateral flank pain score 2.09 0.96 0.032 Hospital stay -0.26 0.43 0.555 Stone free 0.42 0.85 0.625 BMI, body mass index; HT, hypertension; HL, hyperlipidemia; DM, diabetes mellitus; CKD, chronic kidney disease; CRP, C-reactive protein; WBC, white blood cell; DJ, double-J; UAS, ureteral access sheath. Discussion We showed evidence of the efficacy of IRP monitoring in preventing infectious complications in patients with high-infectious risk. Postoperative fever incidence among patients with positive preoperative urine cultures was 7.7%, which was lower than previously reported [ 7 , 8 ]. In this study, RIRS was performed while targeting an IRP of < 30 mmHg. Previous clinical studies using the LVE reported median IRP values of 28.5–32.0 mmHg during RIRS [ 12 , 15 ]. In contrast, the mean IRP in this study was 13.3 mmHg, suggesting that intraoperative monitoring helped maintain lower pressure, thereby reducing the postoperative fever and septic shock risk. Risk factors for postoperative infection reportedly include sex, diabetes mellitus, preoperative UTIs, positive urine cultures, stone sizes, infectious stones, USITs, and operative times [ 7 , 9 , 10 ]. However, no reports have analysed postoperative infection risk factors after RIRS in patients with positive urine cultures. Our study revealed that older age and longer USITs were risk factors for postoperative fever after RIRS in a high-infectious-risk population. USITs before RIRS have been implicated as a risk factor for bacteriuria [ 16 ]. Nevo et al. reported that preoperative stent placement before RIRS should be carefully considered, and if a stent is used, follow-up RIRS should be performed within 1 month [ 16 ]. In the present study, prolonged antibiotic use in patients with positive preoperative urine cultures may have promoted biofilm formation and increased the infection risk. No reports exist regarding the relationship between the pelvicalyceal anatomy and postoperative infections. In this study, a divided pelvis was observed more frequently in the febrile group, although the difference was not statistically significant. A comprehensive cadaveric review demonstrated that a divided pelvis predisposes patients to localised urinary stasis, creating a favourable environment for bacterial colonisation even when preoperative cultures are negative [ 17 ]. Restricted outflow may cause regional high-pressure zones, promoting pyelovenous backflow and facilitating the translocation of bacteria into the systemic circulation. Operative time was not identified as a predictive factor for postoperative fever, unlike in previous reports. This might be because the cumulative period of markedly elevated IRPs was brief. The physiological IRP in a non-dilated collecting system is 0–15 mmHg [ 18 ]. Ex vivo studies on porcine kidneys have shown that pyelotubular backflow occurs at 20–30 mmHg, and pyelovenous backflow occurs at 30–90 mmHg [ 19 , 20 ]. Furthermore, the backflow risk depends not only on the peak pressure but also on the exposure duration; sustained or repeated high-pressure episodes markedly increase fluid absorption and bacterial translocation [ 20 ]. In this study, the time with IRPs > 30 mmHg was extremely short (25.8 seconds [afebrile group]; 4.3 seconds [febrile group]). Because the use of the LVE limited the time spent above the critical IRP, the overall operative time was not a reliable surrogate for infection risk. This observation supports the concept that minimising the cumulative high-pressure time rather than the absolute operative duration is paramount for preventing postoperative infections. The higher IRPs during endoscopic surgery reportedly contribute to adverse events, including postoperative fever, flank pain, and renal subcapsular haemorrhage [ 21 , 22 ]. In this study, the overall IRP levels were low, and the postoperative fever incidence was also low; therefore, the association between elevated IRPs and postoperative fever could not be clearly determined. Contrastingly, this may be the first real-world study to demonstrate an association between increased IRPs during RIRS and postoperative pain. Moreover, elevated IRPs were also associated with higher postoperative WBC counts, suggesting that increased IRPs may induce subclinical inflammatory responses. The IRP during RIRS is primarily governed by the balance between irrigation inflow and outflow; however, non-technical factors contributing to IRP elevation have been less thoroughly investigated. Bhojani et al. reported that Asian ethnicity, preoperative ureteral stent insertion, UAS insertion, and tight ureters were associated with higher IRPs [ 12 ]. Conversely, our study identified BMI, the irrigation method, and the UAS tip position as significant determinants of intraoperative IRP. Because tight ureters are more frequently observed in younger patients [ 23 , 24 ], this anatomical tendency could contribute to higher intrarenal pressure in this age group. Elevated BMI is positively correlated with increased intra-abdominal pressure [ 25 ], which could theoretically increase renal pelvic pressure; however, the concomitant rise in renal venous pressure might prevent pyelovenous backflow and therefore not necessarily increase the infection risk. Automatic irrigation, which adjusts flow according to intraluminal pressure, was the only independent factor that significantly prevented IRP elevation. This effect has also been demonstrated in bench studies [ 26 ]. Additionally, manual pumping in endoscopic combined intrarenal surgery has been identified as a postoperative fever risk factor [ 27 ], highlighting the importance of careful pressure control during manual pumping. Regarding the association between the UAS tip position and IRP, Chew et al. demonstrated in a bench model that placing the UAS tip at the ureteropelvic junction increased the IRP [ 26 ]. However, our real-world data showed the opposite. Other clinical observations have also suggested that keeping the UAS tip close to the ureteroscope improves outflow through the sheath, thereby reducing the IRP [ 28 ]. These findings indicate that securing the UAS tip in an appropriate position may be important for minimising the postoperative infection risk. Overall, IRP reflects the balance between irrigation inflow and outflow, underscoring the importance of outflow assessment for infection prevention. In this study, although differences in IRP by drainage status did not reach statistical significance, lower IRPs were observed in cases with good drainage, whereas higher IRPs occurred in cases with poor drainage. These findings suggest that visual UAS outflow assessment is a simple and clinically meaningful surrogate for pressure control; however, it lacks the precision required to reliably discriminate infection risk. Therefore, direct IRP monitoring provides a more objective and ideal approach for optimising IRP management and preventing postoperative infections. Despite its advantages, routine use of the LVE in RIRS is limited by its larger calibre, sensor fragility, and pressure artefacts. The integrated pressure sensor increases the ureteroscope diameter (9.5 Fr), precluding its use in patients with narrow ureters; consequently, LVE could not be used in 27 cases. In addition, the sensor is vulnerable to intraoperative damage and prone to artefact spikes from contact with the urothelial wall. Although these artefacts can be retrospectively corrected using an AI-based algorithm [ 13 ], real-time correction would further improve pressure-guided decision-making. Nevertheless, real-time IRP monitoring with the LVE enables safer RIRS, even in patients at high risk of infection. This study has some methodological limitations. First, it was designed as a single-arm prospective cohort study comparing historical controls, which should be interpreted with caution. Future randomised trials should confirm these findings and establish safe IRP thresholds for routine practice. Second, the antibiotic choice and duration were determined by the surgeon based on preoperative culture results. Determining whether the antibiotics were fully effective might have required assessing urine cultures immediately before surgery or stone culture results. However, the concordance rates between preoperative urine cultures and stone cultures have been reported to vary significantly [ 29 ], suggesting that IRP monitoring during RIRS remains a useful infection control method. Finally, ureteral stents inserted preoperatively were not standardised in this study. As stent coating could influence bacterial adhesion [ 30 ], differences in stent types might have introduced bias into the analysis of postoperative infections. In conclusion, continuous IRP monitoring with the LVE ureteroscope enabled maintenance of low intrarenal pressures during RIRS and was associated with a low rate of postoperative fever without septic shock. Incorporating IRP monitoring may improve safety in patients with positive urine cultures and facilitate safer, potentially ambulatory RIRS. Declarations Acknowledgments We thank our secretary, Miss Haruna Okada, for contacting the investigators at each institution and collecting the data. Author Contributions S.H.: Conceptualisation, Formal Analysis, Investigation, Writing – Original Draft Preparation. T.I.: Investigation, Conceptualisation, Review & Editing. D.K.: Investigation, Conceptualization, Review & Editing. T.M.: Investigation, Conceptualisation, Review & Editing. R.T.: Investigation, Conceptualisation, Review & Editing. Y.K.: Conceptualisation, Investigation, Conceptualisation, Review & Editing. T.Y.: Review & Editing. R.U.: Investigation, Review & Editing. T.E.: Investigation, Review & Editing. K.T.: Investigation, Review & Editing. T.Y: Supervision, Review & Editing. Ethical considerations This single-arm prospective cohort study was performed at five centres in Japan between August 2023 and October 2024. The study was approved by a central institutional review board through a unified application, specifically the Nagoya City University Certified Research Review Board (approval number: 60-22-0103), which covered all participating institutions in this multicentre study. The study was conducted in accordance with the Declaration of Helsinki and was registered with the Japanese University Hospital Medical Information Network Centre (UMIN ID:000059022). Consent to participate All patients provided written informed consent prior to participation. Consent for publication Not applicable. Declaration of conflicting interest On behalf of all the authors, I declare no potential conflicts of interest. Boston Scientific Corporation, the manufacturer of the LithoVue™ Elite ureteroscope and system, provided ureteroscopes to our five centres as an in-kind contribution. No other financial support or payments were made to institutions, hospitals, or authors related to this study. The company’s involvement is limited to the supply of ureteroscopes. Funding statement This study was funded by the Investigator-Sponsored Research Program of Boston Scientific (ISRURO0116). Data availability The datasets generated or analysed in the present study are available from the corresponding author upon reasonable request. References Türk C, Petřík A, Sarica K, et al. (2016) EAU guidelines on diagnosis and conservative management of urolithiasis . Eur Urol 69(3):468–474. https://doi.org/10.1016/j.eururo.2015.07.040 Geraghty RM, Jones P, Somani BK (2017) Worldwide trends of urinary stone disease treatment over the last two decades: a systematic review. J Endourol 31(6):547–556. https://doi.org/10.1089/end.2016.0895 Krajewski W, Nowak Ł, Tomczak W, et al. (2025) Feasibility and safety of 6.3 Fr vs. 7.5 Fr digital disposable ureteroscopes in retrograde intrarenal surgery: a prospective randomised trial. World J Urol 43(1) : 510. https://doi.org/10.1007/s00345-025-05874-0 Proietti S, Dragos L, Molina W, et al. (2016) Comparison of new single-use digital flexible ureteroscope versus nondisposable fiber optic and digital ureteroscope in a cadaveric model. J Endourol 30(6):655–659. https://doi.org/10.1089/end.2016.0051 Uleri A, Farré A, Izquierdo P, et al. (2024) Thulium fiber laser versus holmium:yttrium aluminum garnet for lithotripsy: a systematic review and meta-analysis. Eur Urol 85(6):529–540. https://doi.org/10.1016/j.eururo.2024.01.011 Inoue T, Tanaka H, Masuda T, et al. (2024) Japanese survey of perioperative complications and ureteral stricture after ureteroscopy with laser lithotripsy for upper urinary tract stones in multicenter collaborative study. Int J Urol 31(7):795–801. https://doi.org/10.1111/iju.15466 Dybowski B, Bres-Niewada E, Rzeszutko M, et al. (2021) Risk factors for infectious complications after retrograde intrarenal surgery – a systematic review and narrative synthesis. Cent Eur J Urol 74(3):437–445. https://doi.org/10.5173/ceju.2021.250 Kobayashi M, Takazawa R, Waseda Y, Tsujii T (2021) How does pre-operative antimicrobial treatment influence the intra-operative culture results and infectious complications in patients with positive baseline bladder urine culture undergoing ureteroscopic lithotripsy? Urolithiasis 49(4):335–344. https://doi.org/10.1007/s00240-020-01240-4 Ripa F, Cerrato C, Tandoğdu Z, et al. (2024) Clinical significance of stone culture during endourological procedures in predicting post-operative urinary sepsis: should it be a standard of care-evidence from a systematic review and meta-analysis from EAU section of Urolithiasis (EULIS). World J Urol 42(1):614. https://doi.org/10.1007/s00345-024-05319-0 Chugh S, Pietropaolo A, Montanari E, Sarica K, Somani BK (2020) Predictors of urinary infections and urosepsis after ureteroscopy for stone disease: a systematic review from EAU section of urolithiasis (EULIS). Curr Urol Rep 21(4):16. https://doi.org/10.1007/s11934-020-0969-2 Tokas T, Gauhar V, Yuen SKK, Somani BK (2025) Current clinical evidence in intrarenal temperature, pressure and suction during retrograde intrarenal surgery: a review of literature. Curr Opin Urol 35(4):390–398. https://doi.org/10.1097/MOU.0000000000001270 Bhojani N, Koo KC, Bensaadi K, et al. (2023) Retrospective first-in-human use of the LithoVue™ Elite ureteroscope to measure intrarenal pressure. BJU Int 132(6):678–685. https://doi.org/10.1111/bju.16173 Yanase T, Hamamoto S, Unno R, et al. (2025) Establishing an AI-based artifact correction system for intrarenal pressure monitoring using the LithoVue™ elite ureteroscope: an EAU endourology and AUSET collaboration: author list. World J Urol 43(1):683. https://doi.org/10.1007/s00345-025-06057-7 Takazawa R, Kitayama S, Uchida Y, et al. (2018) Proposal for a simple anatomical classification of the pelvicaliceal system for endoscopic surgery. J Endourol 32(8):753–758. https://doi.org/10.1089/end.2018.0218 Kayano S, Yanagisawa T, Tomomasa N, et al. (2025) Impact of ureteral access sheath size on intrarenal pressure evaluated by LithoVue™ elite single use ureteroscope. Int Urol Nephrol 57(8):2481–2486. https://doi.org/10.1007/s11255-025-04430-4 Nevo A, Mano R, Baniel J, Lifshitz DA (2017) Ureteric stent dwelling time: a risk factor for post-ureteroscopy sepsis. BJU Int 120(1):117–122. https://doi.org/10.1111/bju.13796 Gandhi KR, Chavan S (2019) Revisiting the morphology of pelvicalyceal system in human cadaveric kidneys with a systematic review of literature. Asian J Urol 6(3):249–255. https://doi.org/10.1016/j.ajur.2018.12.006 Osther PJS, Pedersen KV, Lildal SK, et al. (2016) Pathophysiological aspects of ureterorenoscopic management of upper urinary tract calculi. Curr Opin Urol 26(1):63–69. https://doi.org/10.1097/MOU.0000000000000235 Kottooran C, Twum-Ampofo J, Lee J, et al. (2023) Evaluation of fluid absorption during flexible ureteroscopy in an in vivo porcine model. BJU Int 131(2):213–218. https://doi.org/10.1111/bju.15858 Hong A, du Plessis J, Browne C, Jack G, Bolton D (2023) Mechanism of urosepsis: relationship between intrarenal pressures and pyelovenous backflow. BJU Int 132(5):512–519. https://doi.org/10.1111/bju.16095 Pedersen KV, Liao D, Osther SS, et al. (2012) Distension of the renal pelvis in kidney stone patients: sensory and biomechanical responses. Urol Res 40(4):305–316. https://doi.org/10.1007/s00240-011-0425-3 Whitehurst LA, Somani BK (2017) Perirenal hematoma after ureteroscopy: A systematic review. J Endourol 31(5):438–445. https://doi.org/10.1089/end.2016.0832 Hamamoto S, Okada S, Inoue T, et al. (2020) Prospective evaluation and classification of endoscopic findings for ureteral calculi. Sci Rep 10(1):12292. https://doi.org/10.1038/s41598-020-69158-w Waseda Y, Takazawa R, Kobayashi M, Fuse H, Tamiya T (2022) Risk factors and predictive model for incidence of difficult ureter during retrograde ureteroscopic lithotripsy. Int J Urol 29(6):542–546. https://doi.org/10.1111/iju.14835 Lambert DM, Marceau S, Forse RA (2005) Intra-abdominal pressure in the morbidly obese. Obes Surg 15(9):1225–1232. https://doi.org/10.1381/096089205774512546 Chew BH, Shalabi N, Herout R, et al. (2023) Intrarenal pressure measured using a novel flexible ureteroscope with pressure sensing capabilities: a study of the effects of ureteral access sheath, irrigation, and working channel accessories. J Endourol 37(11):1200–1208. https://doi.org/10.1089/end.2022.0841 Boonyapalanant C, Unno R, Taguchi K, et al. (2025) Effect of using automated irrigation systems on the risk of infectious complications after endoscopic combined intrarenal surgery: a retrospective cohort study. J Endourol 39(9):872–878. https://doi.org/10.1089/end.2024.0758 Rehman J, Monga M, Landman J, et al. (2003) Characterization of intrapelvic pressure during ureteropyeloscopy with ureteral access sheaths. Urology 61(4):713–718. https://doi.org/10.1016/S0090-4295(02)02440-8 Ripa F, Atiya A, Quistini A, et al. (2025) Stone culture, bladder or pelvic urine culture: the most helpful tool for an endourologist – a review of literature from EAU section of endourology. World J Urol 43(1):447. https://doi.org/10.1007/s00345-025-05558-9 Hamamoto S, Chaya R, Taguchi K, et al. (2025) Ureteral stent biomaterial encrustation after endoscopic lithotripsy: a randomized, single-blind study. Sci Rep 15(1):10614. https://doi.org/10.1038/s41598-025-95095-7 Additional Declarations No competing interests reported. Supplementary Files SupplementalMaterial.docx Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 17 May, 2026 Reviewers agreed at journal 12 May, 2026 Reviewers agreed at journal 12 May, 2026 Reviews received at journal 27 Apr, 2026 Reviewers agreed at journal 09 Feb, 2026 Reviewers invited by journal 09 Feb, 2026 Editor assigned by journal 05 Feb, 2026 Submission checks completed at journal 05 Feb, 2026 First submitted to journal 04 Feb, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {\"props\":{\"pageProps\":{\"initialData\":{\"identity\":\"rs-8790860\",\"acceptedTermsAndConditions\":true,\"allowDirectSubmit\":false,\"archivedVersions\":[],\"articleType\":\"Research Article\",\"associatedPublications\":[],\"authors\":[{\"id\":588360061,\"identity\":\"fed3a62e-446e-4450-a4d2-fc84aa2d8dde\",\"order_by\":0,\"name\":\"Shuzo 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Graduate School of Medical Sciences\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Rei\",\"middleName\":\"\",\"lastName\":\"Unno\",\"suffix\":\"\"},{\"id\":588360069,\"identity\":\"d59187ab-a80a-4800-99c2-63801e304b66\",\"order_by\":8,\"name\":\"Toshiki Etani\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Nagoya City University Graduate School of Medical Sciences\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Toshiki\",\"middleName\":\"\",\"lastName\":\"Etani\",\"suffix\":\"\"},{\"id\":588360070,\"identity\":\"0a91359d-ed26-40c4-b7ac-ba420bf99ffa\",\"order_by\":9,\"name\":\"Kazumi Taguchi\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"University of Alabama at Birmingham\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Kazumi\",\"middleName\":\"\",\"lastName\":\"Taguchi\",\"suffix\":\"\"},{\"id\":588360071,\"identity\":\"9e364371-b09b-4971-a9fb-de2a0a0e84cc\",\"order_by\":10,\"name\":\"Takahiro Yasui\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Nagoya City University Graduate School of Medical Sciences\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Takahiro\",\"middleName\":\"\",\"lastName\":\"Yasui\",\"suffix\":\"\"}],\"badges\":[],\"createdAt\":\"2026-02-05 00:23:56\",\"currentVersionCode\":1,\"declarations\":\"\",\"doi\":\"10.21203/rs.3.rs-8790860/v1\",\"doiUrl\":\"https://doi.org/10.21203/rs.3.rs-8790860/v1\",\"draftVersion\":[],\"editorialEvents\":[],\"editorialNote\":\"\",\"failedWorkflow\":false,\"files\":[{\"id\":103056302,\"identity\":\"d33feccd-8271-4bb5-be3f-e1602c190b54\",\"added_by\":\"auto\",\"created_at\":\"2026-02-20 09:05:21\",\"extension\":\"pdf\",\"order_by\":0,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"manuscript-pdf\",\"size\":1009748,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"manuscript.pdf\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-8790860/v1/727e4bbc-f93c-4ab2-ade1-fef2a3ef990f.pdf\"},{\"id\":102447667,\"identity\":\"8107f7e7-f5c2-42ce-8ef3-81aab2059765\",\"added_by\":\"auto\",\"created_at\":\"2026-02-11 17:58:03\",\"extension\":\"docx\",\"order_by\":0,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"supplement\",\"size\":14802,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"SupplementalMaterial.docx\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-8790860/v1/377217fcf21dbe36e2d60595.docx\"}],\"financialInterests\":\"No competing interests reported.\",\"formattedTitle\":\"Intrarenal pressure monitoring in retrograde intrarenal surgery for high- infectious risk populations\",\"fulltext\":[{\"header\":\"Introduction\",\"content\":\"\\u003cp\\u003eUrolithiasis is a common urinary tract disorder with a reported prevalence of 1\\u0026ndash;20% [\\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e1\\u003c/span\\u003e]. The widespread adoption of retrograde intrarenal surgery (RIRS) has been driven by advances in endoscopic miniaturisation, single-use digital ureteroscopes, and improved laser lithotripters [\\u003cspan additionalcitationids=\\\"CR3 CR4\\\" citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e5\\u003c/span\\u003e].\\u003c/p\\u003e \\u003cp\\u003eDespite these developments, postoperative infectious complications remain a clinical concern [\\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e6\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e7\\u003c/span\\u003e]. Postoperative fever occurs in 2.8\\u0026ndash;7.5% of patients after RIRS [\\u003cspan citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e7\\u003c/span\\u003e] and may reach 16% in those with positive preoperative urine cultures despite appropriate antibiotic therapy [\\u003cspan citationid=\\\"CR8\\\" class=\\\"CitationRef\\\"\\u003e8\\u003c/span\\u003e]. Risk factors include both patient characteristics and intraoperative factors, such as positive urine cultures, prolonged ureteral stent dwelling time, longer operative duration, and elevated intrarenal pressure (IRP) [\\u003cspan citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e7\\u003c/span\\u003e, \\u003cspan additionalcitationids=\\\"CR10\\\" citationid=\\\"CR9\\\" class=\\\"CitationRef\\\"\\u003e9\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR11\\\" class=\\\"CitationRef\\\"\\u003e11\\u003c/span\\u003e].\\u003c/p\\u003e \\u003cp\\u003eIRP is determined by irrigation inflow and outflow, yet its intraoperative quantification has been difficult. The LithoVue\\u0026trade; Elite (LVE) ureteroscope enables continuous real-time IRP monitoring during surgery [\\u003cspan citationid=\\\"CR12\\\" class=\\\"CitationRef\\\"\\u003e12\\u003c/span\\u003e]. However, clinical evidence demonstrating its effectiveness in reducing infectious complications remains limited. We therefore evaluated whether IRP-guided RIRS using the LVE reduces postoperative infectious events in patients at high infectious risk.\\u003c/p\\u003e\"},{\"header\":\"Patients and Methods\",\"content\":\"\\u003cdiv id=\\\"Sec3\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eStudy design and participants\\u003c/h2\\u003e \\u003cp\\u003eThis prospective, single-arm multicentre cohort study was conducted at five centres in Japan between August 2023 and October 2024. The protocol was approved by the Nagoya City University Certified Research Review Board (No. 60-22-0103), registered with UMIN (000059022), and performed in accordance with the Declaration of Helsinki. Written informed consent was obtained from all participants.\\u003c/p\\u003e \\u003cp\\u003eEligible patients were aged\\u0026thinsp;\\u0026gt;\\u0026thinsp;20 years, had upper urinary tract calculi requiring RIRS, and had positive preoperative urine cultures. Exclusion criteria included pregnancy, active pyelonephritis or malignancy, recent RIRS within 3 months, nephrostomy tube placement, anaesthetic contraindications, inability to insert a\\u0026thinsp;\\u0026ge;\\u0026thinsp;10 Fr ureteral access sheath (UAS), or technical failure of IRP measurement.\\u003c/p\\u003e \\u003c/div\\u003e\\n\\u003ch3\\u003eSurgical technique\\u003c/h3\\u003e\\n\\u003cp\\u003eAntibiotics were administered according to culture sensitivity at the surgeon\\u0026rsquo;s discretion. All procedures were performed using the LVE ureteroscope under general or spinal anaesthesia. UAS size (10/12, 11/13, or 12/14 Fr) was selected after rigid ureteroscopic assessment. Stones were fragmented using a holmium:YAG laser. Irrigation modality (automatic or manual) was chosen by the surgeon, and flow was adjusted using real-time monitoring to maintain IRP\\u0026thinsp;\\u0026lt;\\u0026thinsp;30 mmHg; renal pelvic aspiration was performed when necessary. A ureteral stent was placed at the end of the procedure and removed within 2 weeks.\\u003c/p\\u003e\\n\\u003ch3\\u003eData collection\\u003c/h3\\u003e\\n\\u003cp\\u003eThe primary outcome was postoperative fever (\\u0026ge;\\u0026thinsp;38\\u0026deg;C) until discharge. Secondary outcomes included systemic inflammatory response syndrome (SIRS) score\\u0026thinsp;\\u0026ge;\\u0026thinsp;2, postoperative C-reactive protein (CRP), stone-free rate (SFR), operative time, intraoperative IRP, ipsilateral flank pain score on postoperative day 1, and complications according to the Clavien\\u0026ndash;Dindo classification. Stone-free status was defined as residual fragments\\u0026thinsp;\\u0026le;\\u0026thinsp;2 mm on CT 1 month postoperatively.\\u003c/p\\u003e \\u003cp\\u003eIRP data were corrected postoperatively using our previously reported artificial intelligence (AI)\\u0026ndash;based artefact correction model [\\u003cspan citationid=\\\"CR13\\\" class=\\\"CitationRef\\\"\\u003e13\\u003c/span\\u003e]. Pelvicalyceal anatomy was classified intraoperatively as Type I or II using the Takazawa classification [\\u003cspan citationid=\\\"CR14\\\" class=\\\"CitationRef\\\"\\u003e14\\u003c/span\\u003e]. UAS outflow was graded subjectively as poor, fair, or good.\\u003c/p\\u003e\\n\\u003ch3\\u003eStatistical analyses\\u003c/h3\\u003e\\n\\u003cp\\u003eSample size was estimated using the two-sided 95% confidence interval for postoperative fever. Assuming a 4% fever rate, 90 patients were required; allowing for dropouts, the target enrolment was 100.\\u003c/p\\u003e \\u003cp\\u003eStatistical analyses were performed using EZR for R (v4.4.1). Categorical variables were compared using Fisher\\u0026rsquo;s exact test and continuous variables using the Mann\\u0026ndash;Whitney U test. Factors associated with elevated IRP were assessed by univariate and multivariate linear regression. A p-value\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.05 was considered significant.\\u003c/p\\u003e\"},{\"header\":\"Results\",\"content\":\"\\u003cp\\u003eOverall, 148 eligible patients were consecutively recruited, and 104 were ultimately enrolled in the study. The exclusion reasons were as follows: 27 patients had tight ureters that precluded the insertion of adequately sized UASs, eight in whom the IRP could not be measured due to mechanical error, seven in whom the LVE was not applied at the surgeon\\u0026rsquo;s discretion, and two in whom the procedure was terminated.\\u003c/p\\u003e \\u003cdiv id=\\\"Sec8\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003ePrimary and secondary outcomes\\u003c/h2\\u003e \\u003cp\\u003eBaseline characteristics and surgical outcomes are summarised in Table\\u0026nbsp;\\u003cspan refid=\\\"Tab1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e. The specific bacteria identified in the urine cultures are listed in Supplementary Table\\u0026nbsp;1. Postoperative fever occurred in 7.7% of patients and SIRS in 3.8%, with no cases of septic shock. The median operative time was 50 min, and the SFR was 80.8%. Grade I and II complications occurred in 2.9% and 4.8%, respectively.\\u003c/p\\u003e \\u003cp\\u003e \\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab1\\\" border=\\\"1\\\"\\u003e \\u003ccaption language=\\\"En\\\"\\u003e \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 1\\u003c/div\\u003e \\u003cdiv class=\\\"CaptionContent\\\"\\u003e \\u003cp\\u003ePatient characteristics and surgical outcomes\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/caption\\u003e \\u003ccolgroup cols=\\\"2\\\"\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e \\u003cthead\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eAge (years), median [IQR]\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e67.0 [56.8\\u0026ndash;74.3]\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003c/thead\\u003e \\u003ctbody\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eSex: female, n (%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e67 (64.4)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eBMI (kg/m\\u003csup\\u003e2\\u003c/sup\\u003e), median [IQR]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e23.8 [21.3\\u0026ndash;27.7]\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eECOG PS, n (%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e51 (49.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e40 (38.5)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e7 (6.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e5 (3.8)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e4\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e1 (1.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eComorbidity and past history, n (%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eHT\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e50 (48.1)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eHL\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e20 (19.2)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eDM\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e22 (21.2)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eCKD\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e39 (37.5)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eFebrile UTI\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e41 (39.4)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003ePreoperative DJ insertion, n (%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e83(79.8)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eStone laterality: right, n (%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e44 (42.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eStone location, n (%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eRenal\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e44 (42.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eProximal ureter\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e46 (44.2)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eMiddle ureter\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e11 (10.6)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eDistal ureter\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e3 (2.9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eStone number, median [IQR]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e1.0 [1.0\\u0026ndash;2.0]\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eStone area (mm\\u003csup\\u003e2\\u003c/sup\\u003e), median [IQR]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e63.5 [33.2\\u0026ndash;117.1]\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eStone volume (mm\\u003csup\\u003e3\\u003c/sup\\u003e), median [IQR]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e293.7 [117.5\\u0026ndash;723.2]\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eCT value, median [IQR]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e1177.0 [854.0\\u0026ndash;1453.0]\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eSurgery time (minutes), median [IQR]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e50.0 [36.8\\u0026ndash;80.0]\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eMaximum IRP (mmHg), median [IQR]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e43.0 [31.0\\u0026ndash;75.0]\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eMean IRP (mmHg), median [IQR]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e13.3 [10.4\\u0026ndash;19.1]\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eDuration with \\u0026gt;\\u0026thinsp;20mmHg IRP (seconds), median [IQR]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e130.7 [15.7\\u0026ndash;418.9]\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eDuration with \\u0026gt;\\u0026thinsp;30mmHg IRP (seconds), median [IQR]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e21.1 [0.6\\u0026ndash;157.9]\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eDuration with \\u0026gt;\\u0026thinsp;40mmHg IRP (seconds), median [IQR]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e0.8 [0.0\\u0026ndash;64.0]\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eClavien\\u0026ndash;Dindo grade, n (%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e96 (92.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eI\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e3 (2.9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eII\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e5 (4.8)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003ePostoperative fever, n (%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e8 (7.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eSIRS score, n (%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e0\\u0026ndash;1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e100 (96.2)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e2\\u0026ndash;4\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e4 (3.8)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eSeptic shock, n (%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e0 (0.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eStone free status (mm), n (%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u0026lt;2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e84 (80.8)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e2.1\\u0026ndash;4\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e6 (5.8)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e\\u0026gt;4\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e14 (13.4)\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003c/tbody\\u003e \\u003c/colgroup\\u003e \\u003ctfoot\\u003e \\u003ctr\\u003e\\u003ctd colspan=\\\"2\\\"\\u003eIQR, interquartile range; BMI, body mass index; ECOG PS, Eastern Cooperative Oncology Group performance status; HT, hypertension; HL, hyperlipidaemia; DM, diabetes mellitus; CKD, chronic kidney disease; UTI, urinary tract infection; DJ, double-J; IRP, intrarenal pressure; SIRS, systemic inflammatory response syndrome; CRP, C-reactive protein.\\u003c/td\\u003e\\u003c/tr\\u003e \\u003c/tfoot\\u003e \\u003c/table\\u003e\\u003c/div\\u003e \\u003c/p\\u003e \\u003c/div\\u003e\\n\\u003ch3\\u003eRisk factors for postoperative fever\\u003c/h3\\u003e\\n\\u003cp\\u003eDetailed variables were compared between the afebrile and febrile groups (Table\\u0026nbsp;\\u003cspan refid=\\\"Tab2\\\" class=\\\"InternalRef\\\"\\u003e2\\u003c/span\\u003e). The median age in the febrile group was significantly higher than in the afebrile group (p\\u0026thinsp;=\\u0026thinsp;0.019). The preoperative ureteral stent indwelling time (USIT) was significantly longer in the febrile group than in the afebrile group (p\\u0026thinsp;=\\u0026thinsp;0.015). Regarding pyelocalyceal anatomy, the febrile group had more divided pelves (Type 2 classification) than the afebrile group; however, this difference was not statistically significant (p\\u0026thinsp;=\\u0026thinsp;0.051). Median postoperative CRP levels and WBC counts were also significantly higher in the febrile group than in the afebrile group (p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.001 and p\\u0026thinsp;=\\u0026thinsp;0.002, respectively). The median length of hospital stay was also significantly longer in the febrile group (p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.001). In contrast, the maximum IRP, mean IRP, and the duration of IRPs\\u0026thinsp;\\u0026gt;\\u0026thinsp;30 mmHg did not differ significantly between the afebrile and febrile groups.\\u003c/p\\u003e \\u003cp\\u003e \\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab2\\\" border=\\\"1\\\"\\u003e \\u003ccaption language=\\\"En\\\"\\u003e \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 2\\u003c/div\\u003e \\u003cdiv class=\\\"CaptionContent\\\"\\u003e \\u003cp\\u003eFactors associated with postoperative fever after RIRS for high-infectious-risk patients\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/caption\\u003e \\u003ccolgroup cols=\\\"4\\\"\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c4\\\" colnum=\\\"4\\\"\\u003e\\u003c/div\\u003e \\u003cthead\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eAfebrile group (96)\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003eFebrile group (8)\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003ep-value\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003c/thead\\u003e \\u003ctbody\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eAge (years), median [IQR]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e66.5 [56.0\\u0026ndash;74.0]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e76.0 [72.0\\u0026ndash;81.3]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.019\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eSex: female, n (%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e60 (62.5)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e7 (87.5)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.254\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eBMI (kg/m\\u003csup\\u003e2\\u003c/sup\\u003e), median [IQR]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e23.8 [21.3\\u0026ndash;27.0]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e26.0 [21.2\\u0026ndash;29.6]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.634\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eECOG PS, n (%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.119\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e49 (51.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e2 (25.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e37 (38.5)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e3 (37.5)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e5 (5.2)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e2 (25.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e3\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e4 (4.2)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e1 (12.5)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e4\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e1 (1.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e0 (0.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eComorbidity \\u0026amp; Past history, n (%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eDM\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e19 (19.8)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e3 (37.5)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.361\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eCKD\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e34 (35.4)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e5 (62.5)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.148\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eFebrile UTI\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e36 (37.5)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e5 (62.5)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.259\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eDuration of antibiotic therapy (days), median [IQR]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e5.0 [0.0\\u0026ndash;11.0]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e5.0 [2.0\\u0026ndash;7.0]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.834\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003ePreoperative DJ insertion, n (%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e75 (78.1)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e8 (100.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.354\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003ePreoperative DJ indwell time (days), median [IQR]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e15.5 [7.0\\u0026ndash;28.0]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e67.0 [30.5\\u0026ndash;90.3]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.015\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003ePreoperative CRP (mg/dL), median [IQR]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e0.17 [0.05\\u0026ndash;0.50]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e0.13 [0.07\\u0026ndash;0.30]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.875\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003ePreoperative WBC (count/\\u0026micro;L), median [IQR]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e6060 [4875\\u0026ndash;7420]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e6785 [ 5027\\u0026ndash;7192[\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.845\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eStone area (mm\\u003csup\\u003e3\\u003c/sup\\u003e), median [IQR]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e293.5 [124.3\\u0026ndash;664.3]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e639.4 [102.4\\u0026ndash;1013.6]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.506\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003ePelvicalyceal anatomy, n (%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.051\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eType 1\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e79 (82.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e4 (50.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eType 2 (Divided pelvis)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e17 (17.7)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e4 (50.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eIrrigation method, n (%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eManual irrigation\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e36 (37.5)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e2 (25.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.707\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eAutomatic irrigation\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e60 (62.5)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e6 (75.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eUAS size, n (%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e1.000\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e10/12F\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e24 (25.5)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e2 (28.6)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e11/13F\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e49 (52.1)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e4 (57.1)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e12/14F\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e21 (22.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e1 (14.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eUAS Tip location, n (%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e1.000\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eRenal Pelvis\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e1 (1.1)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e0 (0.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eUreteropelvic junction\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e28 (30.1)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e3 (37.5)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eProximal ureter\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e58 (62.4)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e5 (62.5)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eMiddle ureter\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e6 (6.5)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e0 (0.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eUAS outflow, n (%)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.404\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003ePoor\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e21 (22.3)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e2 (25.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eFair\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e28 (29.8)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e4 (50.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eGood\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e45 (47.9)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e2 (25.0)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eSurgery time (minutes), median [IQR]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e49.0 [36.0\\u0026ndash;80.0]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e62.5 [47.5\\u0026ndash;70.3]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.383\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003ePostoperative CRP (mg/dL), median [IQR]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e0.32 [0.14\\u0026ndash;0.90]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e6.62 [4.14\\u0026ndash;8.99]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003ePostoperative WBC (count/\\u0026micro;L), median [IQR]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e6780 [5502\\u0026ndash;8347]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e13160 [7165\\u0026ndash;19062]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.002\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eHospital stay (days), median [IQR]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e2.00 [2.00\\u0026ndash;2.00]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e9.00 [6.50\\u0026ndash;10.00]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eMaximum IRP (mmHg), median [IQR]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e43.0 [31.0\\u0026ndash;75.0]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e37.00 [29.5\\u0026ndash;77.3]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.729\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eMean IRP (mmHg), median [IQR]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e13.3 [10.5\\u0026ndash;19.1]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e15.7 [9.7\\u0026ndash;22.1]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.719\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eDuration with \\u0026gt;\\u0026thinsp;30 mmHg IRP (seconds), median [IQR]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e21.1 [0.6\\u0026ndash;151.6]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e63.8 [1.7\\u0026ndash;292.8]\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.722\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003c/tbody\\u003e \\u003c/colgroup\\u003e \\u003ctfoot\\u003e \\u003ctr\\u003e\\u003ctd colspan=\\\"4\\\"\\u003eIQR, interquartile range; BMI, body mass index; ECOG PS, Eastern Cooperative Oncology Group performance status; DM, diabetes mellitus; CKD, chronic kidney disease; UTI, urinary tract infection; UAS, ureteral access sheath; DJ, double-J; CRP, C-reactive protein; WBC, white blood cell; IRP, intrarenal pressure.\\u003c/td\\u003e\\u003c/tr\\u003e \\u003c/tfoot\\u003e \\u003c/table\\u003e\\u003c/div\\u003e \\u003c/p\\u003e\\n\\u003ch3\\u003eIRP monitoring and elevation risk during RIRS\\u003c/h3\\u003e\\n\\u003cp\\u003eAll IRP values presented in this study were AI-adjusted. The maximum IRP was 43.0 (IQR: 31.0\\u0026ndash;75.0) mmHg, and the mean IRP was 13.3 (IQR: 10.4\\u0026ndash;19.1) mmHg. The median durations during which the IRP exceeded 20, 30, and 40 mmHg were 130.7, 21.1, and 0.8 seconds, respectively. Factors associated with elevated IRPs during RIRS are shown in Table\\u0026nbsp;\\u003cspan refid=\\\"Tab3\\\" class=\\\"InternalRef\\\"\\u003e3\\u003c/span\\u003e. Univariate linear regression analysis revealed that higher BMI, irrigation method, and UAS tip location were significantly associated with higher IRP (p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.001, p\\u0026thinsp;\\u0026lt;\\u0026thinsp;0.001, and p\\u0026thinsp;=\\u0026thinsp;0.005, respectively). Automatic irrigation was associated with lower IRPs. In addition, UAS tip placement closer to the renal pelvis was associated with lower IRPs. Regarding surgical outcomes, higher postoperative WBC counts and ipsilateral flank pain scores were associated with elevated IRPs (p\\u0026thinsp;=\\u0026thinsp;0.010 and 0.032, respectively). In the multivariate linear regression model including patient characteristics and surgical factors (excluding surgical outcomes), higher BMI and manual irrigation were identified as independent predictors of higher intraoperative IRPs (p\\u0026thinsp;=\\u0026thinsp;0.042 and 0.009, respectively).\\u003c/p\\u003e \\u003cp\\u003e \\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab3\\\" border=\\\"1\\\"\\u003e \\u003ccaption language=\\\"En\\\"\\u003e \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 3\\u003c/div\\u003e \\u003cdiv class=\\\"CaptionContent\\\"\\u003e \\u003cp\\u003eFactors associated with elevated intrarenal pressure during RIRS\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/caption\\u003e \\u003ccolgroup cols=\\\"9\\\"\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c4\\\" colnum=\\\"4\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c5\\\" colnum=\\\"5\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c6\\\" colnum=\\\"6\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c7\\\" colnum=\\\"7\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"char\\\" char=\\\".\\\" class=\\\"colspec\\\" colname=\\\"c8\\\" colnum=\\\"8\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c9\\\" colnum=\\\"9\\\"\\u003e\\u003c/div\\u003e \\u003cthead\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\" morerows=\\\"1\\\" rowspan=\\\"2\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"3\\\" nameend=\\\"c5\\\" namest=\\\"c3\\\"\\u003e \\u003cp\\u003eUnivariate\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e \\u003cth align=\\\"left\\\" colspan=\\\"3\\\" nameend=\\\"c9\\\" namest=\\\"c7\\\"\\u003e \\u003cp\\u003eMultivariate\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003eBeta\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003eSE\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003ep-value\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003eBeta\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003eSE\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003ep-value\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003c/thead\\u003e \\u003ctbody\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c2\\\" namest=\\\"c1\\\"\\u003e \\u003cp\\u003ePatients and stone characteristics\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eAge\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e-0.05\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.07\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.424\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eSex\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e1.63\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e1.92\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.394\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eBMI\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e0.04\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.01\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e0.03\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e0.02\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e0.042\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eHT\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e-0.31\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e1.85\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.868\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eHL\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e2.95\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e2.35\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.212\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eDM\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e-4.24\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e2.17\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.053\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e-4.09\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e2.07\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e0.051\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eCKD\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e-0.10\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e1.91\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.958\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003ePreoperative CRP\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e-0.20\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.23\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.381\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003ePreoperative WBC\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e-0.001\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e-0.001\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.240\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003ePreoperative DJ insertion\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e-3.97\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e2.24\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.081\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e0.00\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e2.37\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e0.713\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003ePreoperative DJ indwell time\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e-0.04\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.03\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.092\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eStone laterality\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e0.54\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e1.86\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.772\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eStone location (Kidney vs Ureter)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e-0.15\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e1.86\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.932\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eStone volume\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e0.001\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.001\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.505\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003ePelvicalyceal anatomy (Type 1 vs Type 2)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e2.02\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e2.31\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.344\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c2\\\" namest=\\\"c1\\\"\\u003e \\u003cp\\u003eSurgical factors\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eIrrigation method (Manual vs Automatic)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e-7.08\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e1.77\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e\\u0026lt;\\u0026thinsp;0.001\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e-5.50\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e2.09\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e0.009\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eUAS size\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e10/12F\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e(Reference)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e11/13F\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e1.77\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e2.22\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.428\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e12/14F\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e3.06\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e2.69\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.258\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eUAS tip location (Kidney vs Ureter)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e4.35\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e1.54\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.005\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e1.23\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e1.68\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e0.466\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eUAS outflow\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eGood\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e(Reference)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e(Reference)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eFair\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e1.64\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e2.13\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.440\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e1.41\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e2.10\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e0.502\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003ePoor\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e4.04\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e2.34\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.088\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e \\u003cp\\u003e1.78\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c8\\\"\\u003e \\u003cp\\u003e2.37\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e \\u003cp\\u003e0.453\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colspan=\\\"2\\\" nameend=\\\"c2\\\" namest=\\\"c1\\\"\\u003e \\u003cp\\u003eSurgical outcomes\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c5\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003ePostoperative fever (\\u0026ge;\\u0026thinsp;38\\u0026deg;C)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e4.59\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e3.40\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.181\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003ePostoperative CRP\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e0.75\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.44\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.088\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003ePostoperative WBC\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e0.001\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.001\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.010\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eIpsilateral flank pain score\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e2.09\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.96\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.032\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eHospital stay\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e-0.26\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.43\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.555\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eStone free\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e0.42\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c4\\\"\\u003e \\u003cp\\u003e0.85\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c5\\\"\\u003e \\u003cp\\u003e0.625\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c6\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c7\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c8\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c9\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e \\u003c/tr\\u003e \\u003c/tbody\\u003e \\u003c/colgroup\\u003e \\u003ctfoot\\u003e \\u003ctr\\u003e\\u003ctd colspan=\\\"9\\\"\\u003eBMI, body mass index; HT, hypertension; HL, hyperlipidemia; DM, diabetes mellitus; CKD, chronic kidney disease; CRP, C-reactive protein; WBC, white blood cell; DJ, double-J; UAS, ureteral access sheath.\\u003c/td\\u003e\\u003c/tr\\u003e \\u003c/tfoot\\u003e \\u003c/table\\u003e\\u003c/div\\u003e \\u003c/p\\u003e\"},{\"header\":\"Discussion\",\"content\":\"\\u003cp\\u003eWe showed evidence of the efficacy of IRP monitoring in preventing infectious complications in patients with high-infectious risk. Postoperative fever incidence among patients with positive preoperative urine cultures was 7.7%, which was lower than previously reported [\\u003cspan citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e7\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR8\\\" class=\\\"CitationRef\\\"\\u003e8\\u003c/span\\u003e]. In this study, RIRS was performed while targeting an IRP of \\u0026lt;\\u0026thinsp;30 mmHg. Previous clinical studies using the LVE reported median IRP values of 28.5\\u0026ndash;32.0 mmHg during RIRS [\\u003cspan citationid=\\\"CR12\\\" class=\\\"CitationRef\\\"\\u003e12\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR15\\\" class=\\\"CitationRef\\\"\\u003e15\\u003c/span\\u003e]. In contrast, the mean IRP in this study was 13.3 mmHg, suggesting that intraoperative monitoring helped maintain lower pressure, thereby reducing the postoperative fever and septic shock risk.\\u003c/p\\u003e \\u003cp\\u003eRisk factors for postoperative infection reportedly include sex, diabetes mellitus, preoperative UTIs, positive urine cultures, stone sizes, infectious stones, USITs, and operative times [\\u003cspan citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e7\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR9\\\" class=\\\"CitationRef\\\"\\u003e9\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR10\\\" class=\\\"CitationRef\\\"\\u003e10\\u003c/span\\u003e]. However, no reports have analysed postoperative infection risk factors after RIRS in patients with positive urine cultures. Our study revealed that older age and longer USITs were risk factors for postoperative fever after RIRS in a high-infectious-risk population. USITs before RIRS have been implicated as a risk factor for bacteriuria [\\u003cspan citationid=\\\"CR16\\\" class=\\\"CitationRef\\\"\\u003e16\\u003c/span\\u003e]. Nevo et al. reported that preoperative stent placement before RIRS should be carefully considered, and if a stent is used, follow-up RIRS should be performed within 1 month [\\u003cspan citationid=\\\"CR16\\\" class=\\\"CitationRef\\\"\\u003e16\\u003c/span\\u003e]. In the present study, prolonged antibiotic use in patients with positive preoperative urine cultures may have promoted biofilm formation and increased the infection risk. No reports exist regarding the relationship between the pelvicalyceal anatomy and postoperative infections. In this study, a divided pelvis was observed more frequently in the febrile group, although the difference was not statistically significant. A comprehensive cadaveric review demonstrated that a divided pelvis predisposes patients to localised urinary stasis, creating a favourable environment for bacterial colonisation even when preoperative cultures are negative [\\u003cspan citationid=\\\"CR17\\\" class=\\\"CitationRef\\\"\\u003e17\\u003c/span\\u003e]. Restricted outflow may cause regional high-pressure zones, promoting pyelovenous backflow and facilitating the translocation of bacteria into the systemic circulation.\\u003c/p\\u003e \\u003cp\\u003eOperative time was not identified as a predictive factor for postoperative fever, unlike in previous reports. This might be because the cumulative period of markedly elevated IRPs was brief. The physiological IRP in a non-dilated collecting system is 0\\u0026ndash;15 mmHg [\\u003cspan citationid=\\\"CR18\\\" class=\\\"CitationRef\\\"\\u003e18\\u003c/span\\u003e]. Ex vivo studies on porcine kidneys have shown that pyelotubular backflow occurs at 20\\u0026ndash;30 mmHg, and pyelovenous backflow occurs at 30\\u0026ndash;90 mmHg [\\u003cspan citationid=\\\"CR19\\\" class=\\\"CitationRef\\\"\\u003e19\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR20\\\" class=\\\"CitationRef\\\"\\u003e20\\u003c/span\\u003e]. Furthermore, the backflow risk depends not only on the peak pressure but also on the exposure duration; sustained or repeated high-pressure episodes markedly increase fluid absorption and bacterial translocation [\\u003cspan citationid=\\\"CR20\\\" class=\\\"CitationRef\\\"\\u003e20\\u003c/span\\u003e]. In this study, the time with IRPs\\u0026thinsp;\\u0026gt;\\u0026thinsp;30 mmHg was extremely short (25.8 seconds [afebrile group]; 4.3 seconds [febrile group]). Because the use of the LVE limited the time spent above the critical IRP, the overall operative time was not a reliable surrogate for infection risk. This observation supports the concept that minimising the cumulative high-pressure time rather than the absolute operative duration is paramount for preventing postoperative infections.\\u003c/p\\u003e \\u003cp\\u003eThe higher IRPs during endoscopic surgery reportedly contribute to adverse events, including postoperative fever, flank pain, and renal subcapsular haemorrhage [\\u003cspan citationid=\\\"CR21\\\" class=\\\"CitationRef\\\"\\u003e21\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR22\\\" class=\\\"CitationRef\\\"\\u003e22\\u003c/span\\u003e]. In this study, the overall IRP levels were low, and the postoperative fever incidence was also low; therefore, the association between elevated IRPs and postoperative fever could not be clearly determined. Contrastingly, this may be the first real-world study to demonstrate an association between increased IRPs during RIRS and postoperative pain. Moreover, elevated IRPs were also associated with higher postoperative WBC counts, suggesting that increased IRPs may induce subclinical inflammatory responses. The IRP during RIRS is primarily governed by the balance between irrigation inflow and outflow; however, non-technical factors contributing to IRP elevation have been less thoroughly investigated. Bhojani et al. reported that Asian ethnicity, preoperative ureteral stent insertion, UAS insertion, and tight ureters were associated with higher IRPs [\\u003cspan citationid=\\\"CR12\\\" class=\\\"CitationRef\\\"\\u003e12\\u003c/span\\u003e]. Conversely, our study identified BMI, the irrigation method, and the UAS tip position as significant determinants of intraoperative IRP. Because tight ureters are more frequently observed in younger patients [\\u003cspan citationid=\\\"CR23\\\" class=\\\"CitationRef\\\"\\u003e23\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR24\\\" class=\\\"CitationRef\\\"\\u003e24\\u003c/span\\u003e], this anatomical tendency could contribute to higher intrarenal pressure in this age group. Elevated BMI is positively correlated with increased intra-abdominal pressure [\\u003cspan citationid=\\\"CR25\\\" class=\\\"CitationRef\\\"\\u003e25\\u003c/span\\u003e], which could theoretically increase renal pelvic pressure; however, the concomitant rise in renal venous pressure might prevent pyelovenous backflow and therefore not necessarily increase the infection risk.\\u003c/p\\u003e \\u003cp\\u003eAutomatic irrigation, which adjusts flow according to intraluminal pressure, was the only independent factor that significantly prevented IRP elevation. This effect has also been demonstrated in bench studies [\\u003cspan citationid=\\\"CR26\\\" class=\\\"CitationRef\\\"\\u003e26\\u003c/span\\u003e]. Additionally, manual pumping in endoscopic combined intrarenal surgery has been identified as a postoperative fever risk factor [\\u003cspan citationid=\\\"CR27\\\" class=\\\"CitationRef\\\"\\u003e27\\u003c/span\\u003e], highlighting the importance of careful pressure control during manual pumping. Regarding the association between the UAS tip position and IRP, Chew et al. demonstrated in a bench model that placing the UAS tip at the ureteropelvic junction increased the IRP [\\u003cspan citationid=\\\"CR26\\\" class=\\\"CitationRef\\\"\\u003e26\\u003c/span\\u003e]. However, our real-world data showed the opposite. Other clinical observations have also suggested that keeping the UAS tip close to the ureteroscope improves outflow through the sheath, thereby reducing the IRP [\\u003cspan citationid=\\\"CR28\\\" class=\\\"CitationRef\\\"\\u003e28\\u003c/span\\u003e]. These findings indicate that securing the UAS tip in an appropriate position may be important for minimising the postoperative infection risk.\\u003c/p\\u003e \\u003cp\\u003eOverall, IRP reflects the balance between irrigation inflow and outflow, underscoring the importance of outflow assessment for infection prevention. In this study, although differences in IRP by drainage status did not reach statistical significance, lower IRPs were observed in cases with good drainage, whereas higher IRPs occurred in cases with poor drainage. These findings suggest that visual UAS outflow assessment is a simple and clinically meaningful surrogate for pressure control; however, it lacks the precision required to reliably discriminate infection risk. Therefore, direct IRP monitoring provides a more objective and ideal approach for optimising IRP management and preventing postoperative infections.\\u003c/p\\u003e \\u003cp\\u003eDespite its advantages, routine use of the LVE in RIRS is limited by its larger calibre, sensor fragility, and pressure artefacts. The integrated pressure sensor increases the ureteroscope diameter (9.5 Fr), precluding its use in patients with narrow ureters; consequently, LVE could not be used in 27 cases. In addition, the sensor is vulnerable to intraoperative damage and prone to artefact spikes from contact with the urothelial wall. Although these artefacts can be retrospectively corrected using an AI-based algorithm [\\u003cspan citationid=\\\"CR13\\\" class=\\\"CitationRef\\\"\\u003e13\\u003c/span\\u003e], real-time correction would further improve pressure-guided decision-making. Nevertheless, real-time IRP monitoring with the LVE enables safer RIRS, even in patients at high risk of infection.\\u003c/p\\u003e \\u003cp\\u003eThis study has some methodological limitations. First, it was designed as a single-arm prospective cohort study comparing historical controls, which should be interpreted with caution. Future randomised trials should confirm these findings and establish safe IRP thresholds for routine practice. Second, the antibiotic choice and duration were determined by the surgeon based on preoperative culture results. Determining whether the antibiotics were fully effective might have required assessing urine cultures immediately before surgery or stone culture results. However, the concordance rates between preoperative urine cultures and stone cultures have been reported to vary significantly [\\u003cspan citationid=\\\"CR29\\\" class=\\\"CitationRef\\\"\\u003e29\\u003c/span\\u003e], suggesting that IRP monitoring during RIRS remains a useful infection control method. Finally, ureteral stents inserted preoperatively were not standardised in this study. As stent coating could influence bacterial adhesion [\\u003cspan citationid=\\\"CR30\\\" class=\\\"CitationRef\\\"\\u003e30\\u003c/span\\u003e], differences in stent types might have introduced bias into the analysis of postoperative infections.\\u003c/p\\u003e \\u003cp\\u003eIn conclusion, continuous IRP monitoring with the LVE ureteroscope enabled maintenance of low intrarenal pressures during RIRS and was associated with a low rate of postoperative fever without septic shock. Incorporating IRP monitoring may improve safety in patients with positive urine cultures and facilitate safer, potentially ambulatory RIRS.\\u003c/p\\u003e\"},{\"header\":\"Declarations\",\"content\":\"\\u003cp\\u003e\\u003cstrong\\u003eAcknowledgments\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eWe thank our secretary, Miss Haruna Okada, for contacting the investigators at each institution and collecting the data.\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAuthor Contributions\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eS.H.: Conceptualisation, Formal Analysis, Investigation, Writing – Original Draft Preparation. T.I.: Investigation, Conceptualisation, Review \\u0026amp; Editing. D.K.: Investigation, Conceptualization, Review \\u0026amp; Editing. T.M.: Investigation, Conceptualisation, Review \\u0026amp; Editing. R.T.: Investigation, Conceptualisation, Review \\u0026amp; Editing. Y.K.: Conceptualisation, Investigation, Conceptualisation, Review \\u0026amp; Editing. T.Y.: Review \\u0026amp; Editing. R.U.: Investigation, Review \\u0026amp; Editing. T.E.: Investigation, Review \\u0026amp; Editing. K.T.: Investigation, Review \\u0026amp; Editing. T.Y: Supervision, Review \\u0026amp; Editing.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eEthical considerations\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThis single-arm prospective cohort study was performed at five centres in Japan between August 2023 and October 2024. The study was approved by a central institutional review board through a unified application, specifically the Nagoya City University Certified Research Review Board (approval number: 60-22-0103), which covered all participating institutions in this multicentre study. The study was conducted in accordance with the Declaration of Helsinki and was registered with the Japanese University Hospital Medical Information Network Centre (UMIN ID:000059022).\\u0026nbsp;\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eConsent to participate\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eAll patients provided written informed consent prior to participation.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eConsent for publication\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eNot applicable.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eDeclaration of conflicting interest\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eOn behalf of all the authors, I declare no potential conflicts of interest. Boston Scientific Corporation, the manufacturer of the LithoVue™ Elite ureteroscope and system, provided ureteroscopes to our five centres as an in-kind contribution. No other financial support or payments were made to institutions, hospitals, or authors related to this study. The company’s involvement is limited to the supply of ureteroscopes.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eFunding statement\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThis study was funded by the Investigator-Sponsored Research Program of Boston Scientific (ISRURO0116).\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eData availability\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe datasets generated or analysed in the present study are available from the corresponding author upon reasonable request.\\u003c/p\\u003e\"},{\"header\":\"References\",\"content\":\"\\u003col\\u003e\\n\\u003cli\\u003eT\\u0026uuml;rk C, Petř\\u0026iacute;k A, Sarica K,\\u003cem\\u003e \\u003c/em\\u003eet al. (2016)\\u003cem\\u003e \\u003c/em\\u003eEAU guidelines on diagnosis and conservative management of urolithiasis\\u003cem\\u003e. \\u003c/em\\u003eEur Urol 69(3):468\\u0026ndash;474. https://doi.org/10.1016/j.eururo.2015.07.040\\u003c/li\\u003e\\n\\u003cli\\u003eGeraghty RM, Jones P, Somani BK (2017) Worldwide trends of urinary stone disease treatment over the last two decades: a systematic review. J Endourol 31(6):547\\u0026ndash;556. https://doi.org/10.1089/end.2016.0895\\u003c/li\\u003e\\n\\u003cli\\u003eKrajewski W, Nowak Ł, Tomczak W, et al. (2025) Feasibility and safety of 6.3 Fr vs. 7.5 Fr digital disposable ureteroscopes in retrograde intrarenal surgery: a prospective randomised trial. World J Urol 43(1)\\u003cem\\u003e:\\u003c/em\\u003e510. https://doi.org/10.1007/s00345-025-05874-0\\u003c/li\\u003e\\n\\u003cli\\u003eProietti S, Dragos L, Molina W, et al.\\u003cem\\u003e \\u003c/em\\u003e(2016) Comparison of new single-use digital flexible ureteroscope versus nondisposable fiber optic and digital ureteroscope in a cadaveric model. J Endourol 30(6):655\\u0026ndash;659. https://doi.org/10.1089/end.2016.0051\\u003c/li\\u003e\\n\\u003cli\\u003eUleri A, Farr\\u0026eacute; A, Izquierdo P, et al. (2024) Thulium fiber laser versus holmium:yttrium aluminum garnet for lithotripsy: a systematic review and meta-analysis. Eur Urol 85(6):529\\u0026ndash;540. https://doi.org/10.1016/j.eururo.2024.01.011\\u003c/li\\u003e\\n\\u003cli\\u003eInoue T, Tanaka H, Masuda T, et al. (2024) Japanese survey of perioperative complications and ureteral stricture after ureteroscopy with laser lithotripsy for upper urinary tract stones in multicenter collaborative study. Int J Urol 31(7):795\\u0026ndash;801. https://doi.org/10.1111/iju.15466\\u003c/li\\u003e\\n\\u003cli\\u003eDybowski B, Bres-Niewada E, Rzeszutko M, et al.\\u003cem\\u003e \\u003c/em\\u003e(2021) Risk factors for infectious complications after retrograde intrarenal surgery \\u0026ndash; a systematic review and narrative synthesis. Cent Eur J Urol 74(3):437\\u0026ndash;445. https://doi.org/10.5173/ceju.2021.250\\u003c/li\\u003e\\n\\u003cli\\u003eKobayashi M, Takazawa R, Waseda Y, Tsujii T (2021) How does pre-operative antimicrobial treatment influence the intra-operative culture results and infectious complications in patients with positive baseline bladder urine culture undergoing ureteroscopic lithotripsy? Urolithiasis 49(4):335\\u0026ndash;344. https://doi.org/10.1007/s00240-020-01240-4\\u003c/li\\u003e\\n\\u003cli\\u003eRipa F, Cerrato C, Tandoğdu Z, et al. (2024) Clinical significance of stone culture during endourological procedures in predicting post-operative urinary sepsis: should it be a standard of care-evidence from a systematic review and meta-analysis from EAU section of Urolithiasis (EULIS). World J Urol 42(1):614. https://doi.org/10.1007/s00345-024-05319-0\\u003c/li\\u003e\\n\\u003cli\\u003eChugh S, Pietropaolo A, Montanari E, Sarica K, Somani BK (2020) Predictors of urinary infections and urosepsis after ureteroscopy for stone disease: a systematic review from EAU section of urolithiasis (EULIS). Curr Urol Rep 21(4):16. https://doi.org/10.1007/s11934-020-0969-2\\u003c/li\\u003e\\n\\u003cli\\u003eTokas T, Gauhar V, Yuen SKK, Somani BK\\u003cem\\u003e \\u003c/em\\u003e(2025) Current clinical evidence in intrarenal temperature, pressure and suction during retrograde intrarenal surgery: a review of literature. Curr Opin Urol 35(4):390\\u0026ndash;398. https://doi.org/10.1097/MOU.0000000000001270\\u003c/li\\u003e\\n\\u003cli\\u003eBhojani N, Koo KC, Bensaadi K, et al. (2023) Retrospective first-in-human use of the LithoVue\\u0026trade; Elite ureteroscope to measure intrarenal pressure. BJU Int 132(6):678\\u0026ndash;685. https://doi.org/10.1111/bju.16173\\u003c/li\\u003e\\n\\u003cli\\u003eYanase T, Hamamoto S, Unno R, et al. (2025) Establishing an AI-based artifact correction system for intrarenal pressure monitoring using the LithoVue\\u0026trade; elite ureteroscope: an EAU endourology and AUSET collaboration: author list. World J Urol 43(1):683. https://doi.org/10.1007/s00345-025-06057-7\\u003c/li\\u003e\\n\\u003cli\\u003eTakazawa R, Kitayama S, Uchida Y, et al. (2018) Proposal for a simple anatomical classification of the pelvicaliceal system for endoscopic surgery. J Endourol 32(8):753\\u0026ndash;758. https://doi.org/10.1089/end.2018.0218\\u003c/li\\u003e\\n\\u003cli\\u003eKayano S, Yanagisawa T, Tomomasa N, et al. (2025) Impact of ureteral access sheath size on intrarenal pressure evaluated by LithoVue\\u0026trade; elite single use ureteroscope. Int Urol Nephrol 57(8):2481\\u0026ndash;2486. https://doi.org/10.1007/s11255-025-04430-4\\u003c/li\\u003e\\n\\u003cli\\u003eNevo A, Mano R, Baniel J, Lifshitz DA (2017) Ureteric stent dwelling time: a risk factor for post-ureteroscopy sepsis. BJU Int 120(1):117\\u0026ndash;122. https://doi.org/10.1111/bju.13796\\u003c/li\\u003e\\n\\u003cli\\u003eGandhi KR, Chavan S\\u003cem\\u003e \\u003c/em\\u003e(2019) Revisiting the morphology of pelvicalyceal system in human cadaveric kidneys with a systematic review of literature. Asian J Urol 6(3):249\\u0026ndash;255. https://doi.org/10.1016/j.ajur.2018.12.006\\u003c/li\\u003e\\n\\u003cli\\u003eOsther PJS, Pedersen KV, Lildal SK, et al. (2016) Pathophysiological aspects of ureterorenoscopic management of upper urinary tract calculi. Curr Opin Urol 26(1):63\\u0026ndash;69. https://doi.org/10.1097/MOU.0000000000000235\\u003c/li\\u003e\\n\\u003cli\\u003eKottooran C, Twum-Ampofo J, Lee J, et al. (2023) Evaluation of fluid absorption during flexible ureteroscopy in an in vivo porcine model. BJU Int 131(2):213\\u0026ndash;218. https://doi.org/10.1111/bju.15858\\u003c/li\\u003e\\n\\u003cli\\u003eHong A, du Plessis J, Browne C, Jack G, Bolton D (2023) Mechanism of urosepsis: relationship between intrarenal pressures and pyelovenous backflow. BJU Int 132(5):512\\u0026ndash;519. https://doi.org/10.1111/bju.16095\\u003c/li\\u003e\\n\\u003cli\\u003ePedersen KV, Liao D, Osther SS, et al. (2012) Distension of the renal pelvis in kidney stone patients: sensory and biomechanical responses. Urol Res 40(4):305\\u0026ndash;316. https://doi.org/10.1007/s00240-011-0425-3\\u003c/li\\u003e\\n\\u003cli\\u003eWhitehurst LA, Somani BK\\u003cem\\u003e \\u003c/em\\u003e(2017) Perirenal hematoma after ureteroscopy: A systematic review. J Endourol 31(5):438\\u0026ndash;445. https://doi.org/10.1089/end.2016.0832\\u003c/li\\u003e\\n\\u003cli\\u003eHamamoto S, Okada S, Inoue T, et al. (2020) Prospective evaluation and classification of endoscopic findings for ureteral calculi. Sci Rep 10(1):12292. https://doi.org/10.1038/s41598-020-69158-w\\u003c/li\\u003e\\n\\u003cli\\u003eWaseda Y, Takazawa R, Kobayashi M, Fuse H, Tamiya T (2022) Risk factors and predictive model for incidence of difficult ureter during retrograde ureteroscopic lithotripsy. Int J Urol 29(6):542\\u0026ndash;546. https://doi.org/10.1111/iju.14835\\u003c/li\\u003e\\n\\u003cli\\u003eLambert DM, Marceau S, Forse RA (2005) Intra-abdominal pressure in the morbidly obese. Obes Surg 15(9):1225\\u0026ndash;1232. https://doi.org/10.1381/096089205774512546\\u003c/li\\u003e\\n\\u003cli\\u003eChew BH, Shalabi N, Herout R, et al. (2023) Intrarenal pressure measured using a novel flexible ureteroscope with pressure sensing capabilities: a study of the effects of ureteral access sheath, irrigation, and working channel accessories. J Endourol 37(11):1200\\u0026ndash;1208. https://doi.org/10.1089/end.2022.0841\\u003c/li\\u003e\\n\\u003cli\\u003eBoonyapalanant C, Unno R, Taguchi K, et al. (2025) Effect of using automated irrigation systems on the risk of infectious complications after endoscopic combined intrarenal surgery: a retrospective cohort study. J Endourol 39(9):872\\u0026ndash;878. https://doi.org/10.1089/end.2024.0758\\u003c/li\\u003e\\n\\u003cli\\u003eRehman J, Monga M, Landman J, et al. (2003) Characterization of intrapelvic pressure during ureteropyeloscopy with ureteral access sheaths. Urology 61(4):713\\u0026ndash;718. https://doi.org/10.1016/S0090-4295(02)02440-8\\u003c/li\\u003e\\n\\u003cli\\u003eRipa F, Atiya A, Quistini A, et al. (2025) Stone culture, bladder or pelvic urine culture: the most helpful tool for an endourologist \\u0026ndash; a review of literature from EAU section of endourology. World J Urol 43(1):447. https://doi.org/10.1007/s00345-025-05558-9\\u003c/li\\u003e\\n\\u003cli\\u003eHamamoto S, Chaya R, Taguchi K, et al. (2025) Ureteral stent biomaterial encrustation after endoscopic lithotripsy: a randomized, single-blind study. Sci Rep 15(1):10614. https://doi.org/10.1038/s41598-025-95095-7\\u003c/li\\u003e\\n\\u003c/ol\\u003e\"}],\"fulltextSource\":\"\",\"fullText\":\"\",\"funders\":[],\"hasAdminPriorityOnWorkflow\":false,\"hasManuscriptDocX\":true,\"hasOptedInToPreprint\":true,\"hasPassedJournalQc\":\"\",\"hasAnyPriority\":false,\"hideJournal\":false,\"highlight\":\"\",\"institution\":\"\",\"isAcceptedByJournal\":false,\"isAuthorSuppliedPdf\":false,\"isDeskRejected\":\"\",\"isHiddenFromSearch\":false,\"isInQc\":false,\"isInWorkflow\":false,\"isPdf\":false,\"isPdfUpToDate\":true,\"isWithdrawnOrRetracted\":false,\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"world-journal-of-urology\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":false,\"externalIdentity\":\"wjur\",\"sideBox\":\"Learn more about [World Journal of Urology](https://link.springer.com/journal/345)\",\"snPcode\":\"345\",\"submissionUrl\":\"https://submission.nature.com/new-submission/345/3\",\"title\":\"World Journal of Urology\",\"twitterHandle\":\"\",\"acdcEnabled\":true,\"dfaEnabled\":true,\"editorialSystem\":\"stoa\",\"reportingPortfolio\":\"Springer Hybrid\",\"inReviewEnabled\":true,\"inReviewRevisionsEnabled\":false},\"keywords\":\"retrograde intrarenal surgery, intrarenal pressure, postoperative infectious complications, sepsis, LithoVue™ Elite, positive urinary culture\",\"lastPublishedDoi\":\"10.21203/rs.3.rs-8790860/v1\",\"lastPublishedDoiUrl\":\"https://doi.org/10.21203/rs.3.rs-8790860/v1\",\"license\":{\"name\":\"CC BY 4.0\",\"url\":\"https://creativecommons.org/licenses/by/4.0/\"},\"manuscriptAbstract\":\"\\u003ch2\\u003ePurpose\\u003c/h2\\u003e \\u003cp\\u003eTo evaluate whether real-time intrarenal pressure (IRP) monitoring using the LithoVue\\u0026trade; Elite (LVE) ureteroscope reduces infectious complications after retrograde intrarenal surgery (RIRS) in patients with positive urine cultures.\\u003c/p\\u003e\\u003ch2\\u003eMethods\\u003c/h2\\u003e \\u003cp\\u003eThis multicenter, single-arm, prospective cohort study (August 2023\\u0026ndash;October 2024) included patients with upper urinary tract calculi and positive preoperative urine cultures who underwent RIRS with real-time IRP monitoring via the LVE. Irrigation was adjusted to maintain IRPs below 30 mmHg. The primary endpoint was postoperative fever\\u0026thinsp;\\u0026ge;\\u0026thinsp;38\\u0026deg;C. Secondary endpoints included systemic inflammatory response syndrome (SIRS), stone-free rates, ipsilateral flank pain scores, and complications.\\u003c/p\\u003e\\u003ch2\\u003eResults\\u003c/h2\\u003e \\u003cp\\u003eOf 148 eligible patients, 104 were enrolled. The median operative time and artificial intelligence-corrected IRP were 50 min (interquartile range: 36.8\\u0026ndash;80.0) and 13.3 mmHg (10.4\\u0026ndash;19.1), respectively. Postoperative fever occurred in 7.7% of patients, SIRS in 3.8%, and no septic shock was observed. Patients who developed postoperative fever were older (p\\u0026thinsp;=\\u0026thinsp;0.019) and had longer preoperative ureteral stent indwelling times (p\\u0026thinsp;=\\u0026thinsp;0.015). Univariate linear regression analysis demonstrated that higher body mass index (BMI), irrigation method, and ureteral access sheath tip location were significantly associated with higher intraoperative IRP (all p\\u0026thinsp;\\u0026le;\\u0026thinsp;0.005). Higher postoperative white blood cell counts and ipsilateral flank pain scores were also associated with elevated IRP (p\\u0026thinsp;=\\u0026thinsp;0.010 and p\\u0026thinsp;=\\u0026thinsp;0.032, respectively). In multivariate linear regression analysis, higher BMI and manual irrigation remained independent increased intraoperative IRP predictors (p\\u0026thinsp;=\\u0026thinsp;0.042 and p\\u0026thinsp;=\\u0026thinsp;0.009, respectively).\\u003c/p\\u003e\\u003ch2\\u003eConclusion\\u003c/h2\\u003e \\u003cp\\u003eReal-time IRP monitoring using the LVE ureteroscope maintained low intrarenal pressures during RIRS and was associated with substantially less postoperative fever than previously reported in high-risk patients. These findings support incorporating IRP monitoring into RIRS protocols to reduce infectious complications in patients with positive urine cultures.\\u003c/p\\u003e\",\"manuscriptTitle\":\"Intrarenal pressure monitoring in retrograde intrarenal surgery for high- infectious risk populations\",\"msid\":\"\",\"msnumber\":\"\",\"nonDraftVersions\":[{\"code\":1,\"date\":\"2026-02-11 17:57:58\",\"doi\":\"10.21203/rs.3.rs-8790860/v1\",\"editorialEvents\":[{\"type\":\"communityComments\",\"content\":0},{\"type\":\"reviewerAgreed\",\"content\":\"217857638708423609706339191840081516320\",\"date\":\"2026-05-17T10:20:21+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"reviewerAgreed\",\"content\":\"304139468180606774208097359923423864372\",\"date\":\"2026-05-12T14:34:59+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"reviewerAgreed\",\"content\":\"80044374939484980409610395399305779065\",\"date\":\"2026-05-12T08:59:39+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"editorInvitedReview\",\"content\":\"\",\"date\":\"2026-04-27T13:08:19+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"reviewerAgreed\",\"content\":\"171871571851721144559617408847829571871\",\"date\":\"2026-02-09T14:10:11+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"reviewersInvited\",\"content\":\"\",\"date\":\"2026-02-09T09:35:28+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"editorAssigned\",\"content\":\"\",\"date\":\"2026-02-06T02:12:37+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"checksComplete\",\"content\":\"\",\"date\":\"2026-02-05T11:41:03+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"submitted\",\"content\":\"World Journal of Urology\",\"date\":\"2026-02-05T00:11:07+00:00\",\"index\":\"\",\"fulltext\":\"\"}],\"status\":\"published\",\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"world-journal-of-urology\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":false,\"externalIdentity\":\"wjur\",\"sideBox\":\"Learn more about [World Journal of Urology](https://link.springer.com/journal/345)\",\"snPcode\":\"345\",\"submissionUrl\":\"https://submission.nature.com/new-submission/345/3\",\"title\":\"World Journal of Urology\",\"twitterHandle\":\"\",\"acdcEnabled\":true,\"dfaEnabled\":true,\"editorialSystem\":\"stoa\",\"reportingPortfolio\":\"Springer Hybrid\",\"inReviewEnabled\":true,\"inReviewRevisionsEnabled\":false}}],\"origin\":\"\",\"ownerIdentity\":\"a0b6e386-1e16-4f0e-94a8-deac0ca45c7d\",\"owner\":[],\"postedDate\":\"February 11th, 2026\",\"published\":true,\"recentEditorialEvents\":[{\"type\":\"reviewerAgreed\",\"content\":\"217857638708423609706339191840081516320\",\"date\":\"2026-05-17T10:20:21+00:00\",\"index\":32,\"fulltext\":\"\"},{\"type\":\"reviewerAgreed\",\"content\":\"304139468180606774208097359923423864372\",\"date\":\"2026-05-12T14:34:59+00:00\",\"index\":31,\"fulltext\":\"\"},{\"type\":\"reviewerAgreed\",\"content\":\"80044374939484980409610395399305779065\",\"date\":\"2026-05-12T08:59:39+00:00\",\"index\":29,\"fulltext\":\"\"}],\"rejectedJournal\":[],\"revision\":\"\",\"amendment\":\"\",\"status\":\"under-review\",\"subjectAreas\":[],\"tags\":[],\"updatedAt\":\"2026-02-11T17:57:59+00:00\",\"versionOfRecord\":[],\"versionCreatedAt\":\"2026-02-11 17:57:58\",\"video\":\"\",\"vorDoi\":\"\",\"vorDoiUrl\":\"\",\"workflowStages\":[]},\"version\":\"v1\",\"identity\":\"rs-8790860\",\"journalConfig\":\"researchsquare\"},\"__N_SSP\":true},\"page\":\"/article/[identity]/[[...version]]\",\"query\":{\"redirect\":\"/article/rs-8790860\",\"identity\":\"rs-8790860\",\"version\":[\"v1\"]},\"buildId\":\"XKTyCvWXoU3ODBz1xrDgd\",\"isFallback\":false,\"isExperimentalCompile\":false,\"dynamicIds\":[84888],\"gssp\":true,\"scriptLoader\":[]}","source_license":"CC-BY-4.0","license_restricted":false}