MP73-16 CHARACTERIZING UROLITHIASIS IN PATIENTS WITH URINARY DIVERSION

Abstract

You have accessJournal of UrologyStone Disease: Evaluation III1 Apr 2014MP73-16 CHARACTERIZING UROLITHIASIS IN PATIENTS WITH URINARY DIVERSION Evan Carlos, Humberto Martinez-Suarez, Adam Kadlec, and Thomas Turk Evan CarlosEvan Carlos More articles by this author , Humberto Martinez-SuarezHumberto Martinez-Suarez More articles by this author , Adam KadlecAdam Kadlec More articles by this author , and Thomas TurkThomas Turk More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2369AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Urinary diversion itself is a risk factor for urolithiasis. This study describes a cohort of patients with urinary diversion and upper tract urolithiasis and secondarily compares that cohort to a group of patients with urinary diversion without stones. METHODS A database of 620 patients undergoing urinary diversion over an 11-year period (2003-2013) at a single institution was reviewed for stone formers. The subjects were divided into three diversion groups: ileal conduit (IC), neobladder (NB) and continent cutaneous pouch (CCP). Those with stones prior to diversion were excluded. The stone formers were matched 2:1 for age at diversion and gender to yield a control group. Date of stone formation was determined by the first postoperative imaging study indicating stone presence. Key outcomes were time to stone formation and stone composition. RESULTS At a median follow up period of 3.1 years, 28 patients (4.5% of total) had formed a stone; 20 (3.2% of total) had upper tract stones alone. Median follow up for all stone formers was 5.3 years and 1.4 years for controls. NBs had the time to stone formation at 1.31 years (p=0.021) when compared to IC’s 5.51 and CCP’s 8.10 years. A negative correlation was found between time to stone formation and pre-op serum glucose >140 mg/dl (R=-0.557, p=0.003). A positive correlation was noted between patients’ BUN >20 mg/dl and time to stone formation (R=0.395, p=0.041). Age at diversion had a negative correlation with time to stone formation, (R= -0.579; p=0.001). Stone analysis demonstrated no significant difference in primary stone composition among the three diversion groups, although calcium phosphate carbonate stones occurred more in CCPs. CONCLUSIONS A sizeable number of patients form stones after urinary diversion in relatively short-term follow-up. This study suggests that patients with neobladder diversion may form stones sooner than other diversion types. The distribution of stone compositions is similar across diversion types. Pre-operative BUN<20, serum glucose >140, and advanced patient age at time of diversion may be risk factors for upper tract stone formation. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e871 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Evan Carlos More articles by this author Humberto Martinez-Suarez More articles by this author Adam Kadlec More articles by this author Thomas Turk More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...