{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T16:52:25Z","timestamp":1790355145620,"version":"4.1.0"},"reference-count":33,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Endourology"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:p>While percutaneous nephrolithotomy (PCNL) remains the treatment modality of choice for kidney stones larger than 2\u2009cm, infectious complications are most common, ranging from 5% to 32%. We present here a novel technique for potentially improving collecting system sterility during PCNL and initial postoperative outcomes. Retrospective chart analysis data of our irrigation protocol were collected from our first 56 patients between February and July 2019. Traditional prone PCNL was performed in a standard manner using fluoroscopic guidance. Using a ureteral catheter that was placed cystoscopically, a renal pelvis urine culture was taken and subsequently 10\u2009mL of betadine solution was instilled into the collecting system. Gentamicin in normal saline (80\u2009mg\/3\u2009L) was utilized as the irrigant fluid for the first 6\u2009L of irrigation. From this cohort, 57% patients were women and mean age was 60\u2009\u00b1\u200914 years. About 23% of patients were diabetic and 55% were hypertensive. Seventy percent of patients had stone burden &gt;2\u2009cm and no patients had stone burden &lt;1\u2009cm. Fifteen patients had positive urine cultures treated preoperatively, while four patients had contaminated cultures. All patients were treated with our antibiotic irrigation and betadine protocol regardless of preoperative cultures or antibiotics. Mean baseline creatinine level was 0.95\u2009\u00b1\u20090.41, with a mean change of 0.18 at postoperative day 1. Of the 15 (26%) of 56 patients with a systemic inflammatory response syndrome response (two of following four criteria: white blood cells &lt;4 or &gt;12; heart rate &gt;90; hypothermia &lt;96.8\u00b0F or hyperthermia &gt;100.4\u00b0F; and respiratory rate &gt;20), only six patients (11%) were febrile and two patients had positive blood cultures (3%). There were no adverse reactions to the betadine or antibiotic irrigation. We present here our initial experience of a new technique for renal pelvis sterilization and its safety and feasibility using intrarenal instillation of betadine and antibiotic irrigation. No Clinical Trial Registration number applicable.<\/jats:p>","DOI":"10.1089\/end.2020.0695","type":"journal-article","created":{"date-parts":[[2021,3,23]],"date-time":"2021-03-23T04:45:41Z","timestamp":1616474741000},"page":"1320-1325","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Novel Irrigation Protocol for Renal Pelvis Sterilization During Percutaneous Nephrolithotomy: A Pilot Study"],"prefix":"10.1177","volume":"35","author":[{"given":"Arun","family":"Rai","sequence":"first","affiliation":[{"name":"Smith Institute for Urology, Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell, Northwell Health, New Hyde Park, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tareq","family":"Aro","sequence":"additional","affiliation":[{"name":"Smith Institute for Urology, Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell, Northwell Health, New Hyde 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