Use of Antibiotic Based Irrigation for Ureteroscopic Treatment of Urolithiasis

Inclusion Criteria: * Provision of signed and dated informed consent form * Stated willingness to comply with all study procedures and availability for the duration of the study * Diagnosed with urolithiasis (obstructing ureteral stone, large non-obstructing renal stones) warranting surgical intervention in line with American Urological Association guidelines for urolithiasis * At a higher risk for infectious complications following ureteroscopy based on a history of atleast one of the below: * 3 more urinary tract infections over 12 month period not on suppressive antibiotic therapy * Prior infectious complication following ureteroscopy * Placement of ureteral stent in the setting of obstructing ureteral stone with concern for superimposed urinary tract infection * Positive pre-operative urine culture treated with culture-appropriate antimicrobial therapy * Planned for cystoscopy, ureteroscopy with possible laser lithotripsy, and ureteral stent placement * For females of reproductive potential: use of highly effective contraception for at least 1 month prior to screening and agreement to use such a method during study participation and for an additional 8 weeks after the end of gentamicin administration. Female patients of reproductive potential will have pregnancy screen prior to surgery per standard operating room protocol. * For males of reproductive potential: use of condoms or other methods to ensure effective contraception with partner Exclusion Criteria: * Estimated Glomerular Filtration Rate less than 60 mL/min * History of sensorineural hearing loss, vertigo, idiopathic dizziness * Active pregnancy or currently lactating * Known allergic reactions to components of gentamicin * Administration of intravenous gentamicin as part of surgical antibiotic prophylaxis