Higher Risk of Repeat Stone Surgery in Stone Formers With Concomitant Bowel Disease: Single-Center Long-Term Analysis

Abstract

ObjectivesTo identify the need for repeat stone surgery in patients with and without bowel disease. Few studies have compared risks between different types of bowel disease and whether their need for repeat stone surgery differs. MethodsFrom our IRB approved study, we identified patients with and without bowel disease. We categorized patients’ bowel disease into 4 categories: inflammatory bowel disease (IBD), bypass procedures, bowel resection, and bowel disease not otherwise specified (e.g., irritable bowel syndrome, celiac disease). Differences between patient demographics, stone disease, and recurrent stone events for patients with and without bowel disease were compared using univariate and multivariate survival analyses (SPSS 25). ResultsOf all surgical stone patients (2011), 484 (24%) had some type of bowel disease. Compared to patients without bowel disease, patients with bowel disease presented with stones at an older age (62.2±14.5 vs. 58.4±15.3 years; p<0.001) and were more likely to be female (56 vs. 46%; p<0.001). Patients with bowel disease required more repeat stone surgery than those without bowel disease (31 vs. 23%, p<0.001). In multivariate analysis, patients with bypass and bowel resection were associated with more repeat surgery than patients without bowel disease (p<0.001, p=0.002, respectively). Patients with IBD and bowel disease not otherwise specified did not have higher risk for repeat surgery than patients without bowel disease. ConclusionsSurgical stone patients with bowel disease, specifically those with prior bowel resection and bypass, had a higher risk of repeat stone surgery over time than stone formers without bowel disease. Data AvailabilityThe data sets generated and analyzed during the current study are available from the corresponding author on reasonable request.