MP11-03 CONTEMPORARY IMAGING PRACTICE PATTERNS AFTER URETEROSCOPY FOR STONE DISEASE

Abstract

You have accessJournal of UrologyImaging/Radiology: Uroradiology II1 Apr 2015MP11-03 CONTEMPORARY IMAGING PRACTICE PATTERNS AFTER URETEROSCOPY FOR STONE DISEASE Mohamed Omar, Hemant Chaparala, Manoj Monga, and Sri Sivalingam Mohamed OmarMohamed Omar More articles by this author , Hemant ChaparalaHemant Chaparala More articles by this author , Manoj MongaManoj Monga More articles by this author , and Sri SivalingamSri Sivalingam More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.384AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Routine imaging following ureteroscopy for treatment of renal/ureteral calculi continues to be a topic of debate. However, with the increasing focus on healthcare costs and quality, judicious use of diagnostic imaging to optimize outcomes while minimizing resource utilization is a priority. We sought to identify post-ureteroscopy imaging practices amongst experienced urologists. METHODS A REDcap questionnaire was sent to urologists in North America. The questionnaire surveyed demographic data, clinical volume, and imaging preferences post-ureteroscopy. Additionally, we surveyed the extent to which stone, anatomic, and procedure-related factors influenced these preferences. The likelihood of altering clinical practice and the desire for specific imaging guidelines were also assessed. The Interquartile range (IQR) was utilized as a measure of median consensus, with a lower IQR denoting increased agreement. RESULTS Three hundred twenty two urologists completed the questionnaire. The mean number of years in practice was 18±10; 82% of respondents performed more than 5 ureteroscopic stone procedures monthly. Routine postoperative imaging was obtained by 48% of participants as follows: US (47%), KUB (17%), CT (4%), IVP (2%), and KUB + US (30%). Urologists who did not routinely image patients were more concerned about cost (55% Vs. 25%, p= <.0001), radiation exposure (69% vs. 44%, p= <.0001), and diagnostic inaccuracy of US (57% vs. 44%, p= <0.02). These urologists were also less likely to have completed an Endourology fellowship (7% vs. 23%, p= <.0001). The most compelling predictors of obtaining postoperative imaging were post-op pain and fever (median 5, IQR 1), residual stones (median 5, IQR 1), ureteral perforation (median 5, IQR 2), and presence of a solitary kidney (median 4.5, IQR 2). CONCLUSIONS Currently, about 50% of urologists who regularly perform ureteroscopic stone procedures obtain post-op imaging. Imaging preferences were guided by the presence of residual fragments, ureteral perforation, solitary kidney, and postoperative pain or fever. Factors discouraging routine imaging & expectations of future change Routine imaging Non-routine imaging p-value Cost of imaging 38 (25%) 93 (55%) .0001 Access to imaging 19 (13%) 11 (7%) .0610 Radiation Hazards 66 (44%) 116 (70%) .0001 Accuracy of ultrasound 66 (44%) 96 (57%) .0192 Anticipate Change of Practice 16 (11%) 13 (8%) .3918 Guideline Importance 94 (62%) 95 (57%) .3006 © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e119-e120 Peer Review Report Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mohamed Omar More articles by this author Hemant Chaparala More articles by this author Manoj Monga More articles by this author Sri Sivalingam More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...