ArticleCureus2025
Utility of the Drain Fluid-to-Serum Creatinine Ratio for Diagnosing Postoperative Complications Following Genitourinary Surgery in Moroccan Patients.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
backgroundPostoperative complications represent a major challenge in genitourinary surgery. The drain fluid-to-plasma (serum) creatinine (DCr/PCr) ratio has emerged as a simple, cost-effective biochemical marker for detecting postoperative urinary leakage.
objectiveTo evaluate the diagnostic performance of the DCr/PCr ratio in identifying postoperative urinary leakage in a Moroccan patient cohort.
methodsA retrospective study was conducted on 118 patients who underwent genitourinary surgery between May 2022 and April 2024. Simultaneous serum and drain fluid creatinine measurements, performed during the first postoperative days, were analyzed alongside clinical and demographic data.
resultsThe cohort had a mean age of 65.36 years and was predominantly male (95.8%). Laparoscopic radical prostatectomy (51.7%) and radical cystectomy with urinary diversion (22.9%) were the most common procedures. The mean DCr/PCr ratio was markedly higher in patients with urinary leakage (22.48) than in those without leakage (1.63). ROC curve analysis demonstrated excellent diagnostic accuracy, with an area under the curve (AUC) of 0.977 (95% CI: 0.949-0.996). A cutoff value of ≥4.0 yielded a sensitivity of 86.7%, specificity of 97.1%, and a negative predictive value of 98.0%.
conclusionThe DCr/PCr ratio is a highly accurate, rapid, and cost-effective tool for detecting postoperative urinary leakage. A cutoff of ≥4.0 provides excellent diagnostic performance, particularly for ruling out leakage. Routine integration of this biochemical marker into postoperative assessment protocols may improve early detection and reduce unnecessary imaging, although prospective multicenter validation remains warranted.
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