MP13-12 PRACTICE PATTERNS AND PREDICTORS OF URINARY STONE MATERIAL SUBMISSION FOR ANALYSIS FOLLOWING URETEROSCOPY: RESULTS FROM A STATEWIDE SURGICAL COLLABORATIVE

Abstract

You have accessJournal of UrologyCME1 May 2022MP13-12 PRACTICE PATTERNS AND PREDICTORS OF URINARY STONE MATERIAL SUBMISSION FOR ANALYSIS FOLLOWING URETEROSCOPY: RESULTS FROM A STATEWIDE SURGICAL COLLABORATIVE Isaac Palma-Zamora, Stephanie Daignault-Newton, Mohit Butaney, Grace Yaguchi, David Leavitt, Casey Dauw, Khurshid Ghani, Naveen Kachroo, and for the Michigan Urological Surgery Improvement Collaborative Isaac Palma-ZamoraIsaac Palma-Zamora More articles by this author , Stephanie Daignault-NewtonStephanie Daignault-Newton More articles by this author , Mohit ButaneyMohit Butaney More articles by this author , Grace YaguchiGrace Yaguchi More articles by this author , David LeavittDavid Leavitt More articles by this author , Casey DauwCasey Dauw More articles by this author , Khurshid GhaniKhurshid Ghani More articles by this author , Naveen KachrooNaveen Kachroo More articles by this author , and for the Michigan Urological Surgery Improvement Collaborative More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002542.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Current American Urological Association guidelines on the surgical management of stones support the submission of stone material for analysis following ureteroscopy to guide treatment and future preventative strategies. We sought to evaluate statewide practice patterns and identify predictors of post-procedural urinary stone submission for analysis. METHODS: All patients undergoing primary ureteroscopy for the management of urolithiasis from 2016 to 2021 were identified using the Michigan Urological Surgery Improvement Collaborative’s Reducing Operative Complications from Kidney Stones (MUSIC ROCKS) prospectively collected clinical registry from contributing practices performing at least 10 ureteroscopic procedures. We determined rates of stone analysis performance at the time of ureteroscopy across practices and demographic, clinical, stone and procedural factors were collected for all patients, stratified by stone analysis submission. Multivariable logistic regression was used to identify predictors of stone submission for analysis following ureteroscopy. RESULTS: A total of 19,027 cases were identified from 32 practices. Stone was sent for analysis 78% of the time with submission rates varying widely across participating practices from 2-99% (Figure 1). In cases where all stones were removed via basketing, stone submission rate was 90% compared to 57% where stone basketing was partially or not used at all (p < 0.0001). On multivariate analysis, larger (>15mm) (OR 0.6; 95%CI:0.47-0.72, p<0.0001) and renally located stones (OR 0.5; 95%CI:0.45-0.55, p<0.0001) were less likely to be sent. On the contrary, stones were more likely to be submitted in patients with private versus public insurance (OR 1.1; 95%CI: 1.03-1.23, p=0.02) and those with stones that were extracted with basket only (OR 2; 95%CI:1.8-2.3, p < 0.0001). CONCLUSIONS: Wide variation exists amongst practices regarding the stone analysis performance at the time of ureteroscopy. This may be influenced by surgical approach and stone factors including size and location. Source of Funding: Blue Cross Blue Shield of Michigan © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e226 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Isaac Palma-Zamora More articles by this author Stephanie Daignault-Newton More articles by this author Mohit Butaney More articles by this author Grace Yaguchi More articles by this author David Leavitt More articles by this author Casey Dauw More articles by this author Khurshid Ghani More articles by this author Naveen Kachroo More articles by this author for the Michigan Urological Surgery Improvement Collaborative More articles by this author Expand All Advertisement PDF DownloadLoading ...