Risk Factors for Post-PCNL Systemic Inflammatory Response Syndrome in Patients with Negative Preoperative Urine Culture: A Prospective Observational Study

Introduction: Percutaneous Nephrolithotomy (PCNL) is the standard treatment for large renal stones. Despite sterile preoperative urine cultures, Systemic Inflammatory Response Syndrome (SIRS) continues to be a common and potentially serious postoperative complication, occurring in up to 30% of cases. This suggests that conventional urine culture alone may not identify all patients at risk. Clinical co-morbidities such as diabetes mellitus, stone burden, operative duration, and inflammatory bioma