Dr. Julie Riley

But some of the more severe complications, I do talk about infections and I will highlight that some of these patients can get quite sick, particularly these very large stones, patients that have complex anatomy infections. These are a lot of the patients that I'm seeing that are referred to me. And so I do really highlight this infection risk and that that is not a minuscule thing.

The other thing I do talk about is the chance of either not being able to get the scope into the kidney, either, you know, a tight ureter, something like that, that that's a possibility. And then also strictures and scarring in the future. and that we do need to continue to monitor them afterwards.

The other thing I do talk about is the chance of either not being able to get the scope into the kidney, either, you know, a tight ureter, something like that, that that's a possibility. And then also strictures and scarring in the future. and that we do need to continue to monitor them afterwards.

The other thing I do talk about is the chance of either not being able to get the scope into the kidney, either, you know, a tight ureter, something like that, that that's a possibility. And then also strictures and scarring in the future. and that we do need to continue to monitor them afterwards.

And I think the other thing that we really, I wish that we did better, and I try to do this as well, is to really talk about this is a long-term disease and that they're going to need follow-up after that ureteroscopy. So it's not even just the complication of the surgery, but this is a disease process that needs managed.

And I think the other thing that we really, I wish that we did better, and I try to do this as well, is to really talk about this is a long-term disease and that they're going to need follow-up after that ureteroscopy. So it's not even just the complication of the surgery, but this is a disease process that needs managed.

And I think the other thing that we really, I wish that we did better, and I try to do this as well, is to really talk about this is a long-term disease and that they're going to need follow-up after that ureteroscopy. So it's not even just the complication of the surgery, but this is a disease process that needs managed.

I think the biggest thing is prevention. So making sure that you've actually worked up the patient beforehand. I get routinely a urine culture on all of my patients. I'm going to treat them with antibiotics if that is positive for at least five to seven days beforehand. I give very strong antibiotics perioperatively to make sure that we avoid any of those infections.

I think the biggest thing is prevention. So making sure that you've actually worked up the patient beforehand. I get routinely a urine culture on all of my patients. I'm going to treat them with antibiotics if that is positive for at least five to seven days beforehand. I give very strong antibiotics perioperatively to make sure that we avoid any of those infections.

I think the biggest thing is prevention. So making sure that you've actually worked up the patient beforehand. I get routinely a urine culture on all of my patients. I'm going to treat them with antibiotics if that is positive for at least five to seven days beforehand. I give very strong antibiotics perioperatively to make sure that we avoid any of those infections.

And if I see any signs of infection during the case, so if they're having purulence, maybe in the PACU that they're not exactly behaving as well as they should, I'm going to certainly have a low threshold to put those patients onto antibiotics for a period of time afterwards.

And if I see any signs of infection during the case, so if they're having purulence, maybe in the PACU that they're not exactly behaving as well as they should, I'm going to certainly have a low threshold to put those patients onto antibiotics for a period of time afterwards.

And if I see any signs of infection during the case, so if they're having purulence, maybe in the PACU that they're not exactly behaving as well as they should, I'm going to certainly have a low threshold to put those patients onto antibiotics for a period of time afterwards.

The vast majority of my patients, however, they're getting a one time dose perioperatively because the vast majority of patients, that's truly what they need. But these patients that come in with infections already, they were already stented for their pyelonephritis. I'm going to be much more liberal with the use of antibiotics and making sure that I'm very directed based upon cultures.

The vast majority of my patients, however, they're getting a one time dose perioperatively because the vast majority of patients, that's truly what they need. But these patients that come in with infections already, they were already stented for their pyelonephritis. I'm going to be much more liberal with the use of antibiotics and making sure that I'm very directed based upon cultures.

The vast majority of my patients, however, they're getting a one time dose perioperatively because the vast majority of patients, that's truly what they need. But these patients that come in with infections already, they were already stented for their pyelonephritis. I'm going to be much more liberal with the use of antibiotics and making sure that I'm very directed based upon cultures.

Yeah, I typically give ampicillin and gentamicin for my perioperative period. If I truly believe that they had an infection, but we missed the culture, right, because they got the dose of antibiotics in the ER before we ever even saw them. That's a very common scenario. Then I'm usually going to give something like, you know, sulfamethazole or, you know, some sort of cephalosporin beforehand.

Yeah, I typically give ampicillin and gentamicin for my perioperative period. If I truly believe that they had an infection, but we missed the culture, right, because they got the dose of antibiotics in the ER before we ever even saw them. That's a very common scenario. Then I'm usually going to give something like, you know, sulfamethazole or, you know, some sort of cephalosporin beforehand.

Yeah, I typically give ampicillin and gentamicin for my perioperative period. If I truly believe that they had an infection, but we missed the culture, right, because they got the dose of antibiotics in the ER before we ever even saw them. That's a very common scenario. Then I'm usually going to give something like, you know, sulfamethazole or, you know, some sort of cephalosporin beforehand.

if I truly believe that they have something that, you know, is really at risk. And that's going to be how I manage them preoperatively. Postoperatively, I really try to get them off of their antibiotics as much as possible because once they're stone free, really most of those risks should be gone.