Are we far from getting it right? Contemporary practices in culturing urine pre‐ureteroscopy

Are we far from getting it right?Contemporary practices in culturing urine pre-ureteroscopy Urosepsis is an important and concerning complication of ureteroscopy (URS), and unfortunately is quite common, with an incidence of ~5% [1,2].Clearly, urologists must take measures to minimise this risk, in which respect the necessity for, and management of, preoperative urine cultures is a frequent endourological debate.There is conflicting evidence regarding the association of preoperative asymptomatic bacteriuria (ASB) with postoperative urinary tract infection (UTI) [3,4].Accordingly, international guidance is sparse and inconsistent, and preoperative pathways for urine culture and its treatment differ between institutions.Earlier this year, an NHS England programme designed to improve patient care ('Getting it Right First Time' [GIRFT]) established an Expert Working Group, which published a 'Guide to preoperative testing: Urine testing before elective urological surgery' [5], with the aims to provide guidance and promote a standardised approach to the 'screening, management and treatment for urinary infections. ..prior to elective urological surgery'.Just prior to the publication of these GIRFT guidelines, and without dissemination of their content, the British Urological Researchers in Surgical Training (BURST) and the BAUS Section of Endourology surveyed urologists in the UK and Ireland to explore contemporary perceptions and practices in this area.In this research letter, we present our findings, outlining how current practice compares to the new guideline's recommendations and highlighting potential challenges to their implementation.