PD34-03 COMPARISON OF STONE-RELATED EVENTS AFTER URETEROSCOPY IN PATIENTS WITH AND WITHOUT RESIDUAL FRAGMENTS

Abstract

You have accessJournal of UrologyStone Disease: Surgical Therapy V (PD34)1 Apr 2020PD34-03 COMPARISON OF STONE-RELATED EVENTS AFTER URETEROSCOPY IN PATIENTS WITH AND WITHOUT RESIDUAL FRAGMENTS Ryan L. Steinberg*, Brett A. Johnson, Alaina Garbens, Igor Sorokin, Joseph Crivelli, Abdulhadi Akhtar, Vishnuvardhan Ganesan, Jodi Antonelli, and Margaret Pearle Ryan L. Steinberg*Ryan L. Steinberg* More articles by this author , Brett A. JohnsonBrett A. Johnson More articles by this author , Alaina GarbensAlaina Garbens More articles by this author , Igor SorokinIgor Sorokin More articles by this author , Joseph CrivelliJoseph Crivelli More articles by this author , Abdulhadi AkhtarAbdulhadi Akhtar More articles by this author , Vishnuvardhan GanesanVishnuvardhan Ganesan More articles by this author , Jodi AntonelliJodi Antonelli More articles by this author , and Margaret PearleMargaret Pearle More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000905.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: We previously showed that nearly half the patients left with residual fragments (RFs) after URS experience a subsequent stone-related event (SE). We aimed to determine if a stone free state after URS is associated with a fewer SEs than those left with residual fragments. METHODS: After undergoing URS for renal and ureteral calculi between December 2015 and February 2017 167 patients (209 renal units, RUs) were prospectively enrolled. CT was obtained 6-8 weeks post-operatively. Patients were evaluated at subsequent office visits and/or contacted by phone to determine if a stone event attributable to the treated RU occurred. A stone event (SE) was defined as spontaneous stone passage, symptoms requiring emergency department (ED) visit, surgical intervention, or stone growth. Only patients with at least 12 months of follow-up were included for analysis. Kaplan Meier analysis, Chi-squared analysis, log rank test, and logistic regression were used to assess outcomes. RESULTS: Among the study group, 123 patients and 152 RUs met study criteria, including 57% (87 RUs) with residual fragments and 43% (65 RUs) who were rendered stone-free on post URS CT. Median overall follow-up was 29 months (IQR 22-34). The mean number of RFs per patient was 2.1 ± 1.5 and mean largest fragment size was 3.7 ± 2.0 mm. SE occurred in 47% (41/87) of RUs with RFs and 14% (9/65) of those that were stone free (p<0.001). Median time to SE was 33 months for those with RFs (CI 23-43) and 45 months in those who were stone free (CI 40-50). The stone event-free survival was 68% in those with RFs and 98% in those stone free at 24 months (p<0.001) (Figure 1). Multivariate regression demonstrated stone-free status as a predictor of a stone event (OR 4.98, p<0.001), although residual fragment size and number were not. CONCLUSIONS: Attaining a stone-free state after URS with basket extraction reduces the rate of SEs in patients undergoing ureteroscopy. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e712-e712 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ryan L. Steinberg* More articles by this author Brett A. Johnson More articles by this author Alaina Garbens More articles by this author Igor Sorokin More articles by this author Joseph Crivelli More articles by this author Abdulhadi Akhtar More articles by this author Vishnuvardhan Ganesan More articles by this author Jodi Antonelli More articles by this author Margaret Pearle More articles by this author Expand All Advertisement PDF downloadLoading ...