MP68-01 USE OF DUSTING TECHNIQUE: RISK OF REPEAT INTERVENTION AFTER URETEROSCOPY FOR RENAL AND URETERAL STONES

Abstract

You have accessJournal of UrologyStone Disease: Surgical Therapy IV1 Apr 2018MP68-01 USE OF DUSTING TECHNIQUE: RISK OF REPEAT INTERVENTION AFTER URETEROSCOPY FOR RENAL AND URETERAL STONES Viacheslav Iremashvili, Shuang Li, Sean P. Hedican, Sara L. Best, and Stephen Y. Nakada Viacheslav IremashviliViacheslav Iremashvili More articles by this author , Shuang LiShuang Li More articles by this author , Sean P. HedicanSean P. Hedican More articles by this author , Sara L. BestSara L. Best More articles by this author , and Stephen Y. NakadaStephen Y. Nakada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2205AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Some patients who undergo ureteroscopy and laser lithotripsy (URS) have residual stone fragments (RFs). The goal of this study was to find out if the presence of RFs increased the risk of repeat surgery in the same renal unit among patients who underwent URS at our institution. METHODS The study included 215 patients who had URS for nephrolithiasis at out hospital between 2008 to 2016, had imaging within 3 months after the intervention and at least one year of follow-up. Dusting technique of laser lithotripsy was used. Patients were divided into subgroups based on the presence of RFs and the size of the largest fragment seen on the first postoperative imaging. Most patients had plain abdominal X-rays (71%), while computerized tomography was done in 16% and ultrasound in 13%. Multivariate Cox regression analysis was performed to compare the risk of repeat surgery among patients with different volumes of residual nephrolithiasis to that in patients with no stones on the first postoperative imaging. RESULTS No RFs were found in 134 (62.3%) patients while 17 (7.9%), 21 (9.8%), 14 (6.5%) and 29 (13.5%) had stones of up to 2 mm, 3-4 mm, 5-6 mm and more than 6 mm respectively. Over a median follow-up of 2.2 years (mean 2.9, IQR 1.5-3.9 years) 61 (28.4%) patients required another surgery on the same renal unit for symptomatic stone disease. Table 1 demonstrates results of the multivariate Cox regression analysis which compared the treatment-free survival depending on the postoperative stone burden. The risk of repeat surgery was increased in all subgroups of patients with RFs, however it was lowest among patients with stones less than 2 mm and 3-4 mm in size. These patients were combined into one group for the Figure 1 which shows the repeat surgery-free survival curves. CONCLUSIONS Our findings suggest that even small residual stone burden seen on the imaging after URS is associated with increased risk of repeat surgical interventions. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e916 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Viacheslav Iremashvili More articles by this author Shuang Li More articles by this author Sean P. Hedican More articles by this author Sara L. Best More articles by this author Stephen Y. Nakada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...