PII-01 ROUTINE IMAGING FOLLOWING PERCUTANEOUS NEPHROLITHOTOMY: SHOULD WE BE SCREENING FOR SILENT OBSTRUCTION?

Abstract

You have accessJournal of UrologyPlenary Session II: Best Abstracts1 Apr 2014PII-01 ROUTINE IMAGING FOLLOWING PERCUTANEOUS NEPHROLITHOTOMY: SHOULD WE BE SCREENING FOR SILENT OBSTRUCTION? Lawrence Dagrosa, Rachel Moses, and Vernon Pais Lawrence DagrosaLawrence Dagrosa More articles by this author , Rachel MosesRachel Moses More articles by this author , and Vernon PaisVernon Pais More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1142AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives Obstruction is a potentially serious complication following upper tract instrumentation. As such, routine renal imaging following ureteroscopy has been recommended to screen for post-operative asymptomatic “silent” hydronephrosis. We could find no published data however on the rates of silent hydronephrosis following percutaneous nephrolithotripsy (PCNL). We assessed the incidence of silent hydronephrosis in a single endourologic practice following both Ureteroscopy and PCNL. Methods Using billing data, 488 patients were identified as having ureteral stent removal by a single surgeon from 2008 to 2013 after undergoing ureteroscopy or PCNL for urinary calculi. Routine follow-up imaging reports were reviewed and the degree of hydronephrosis noted (none, mild, moderate or severe.) Patients found to have ultrasonic evidence of hydronephrosis that was new or worse compared to pre-op imaging were further analyzed for resolution of hydro, time to resolution and need for intervention. Results Of the 488 patients identified 16 (3.3%) were found to have new or worsened hydronephrosis on routine follow-up ultrasound. In the ureteroscopy group 9 of 367 (2.4%) had evidence of hydro, 5 resolved spontaneously, 2 had functional imaging negative for obstruction and 2 had obstruction requiring intervention (endoureterotomy). In the PCNL group 7 of 121 patients (5.7%) had evidence of hydronephrosis at routine follow-up, 5 resolved spontaneously, 1 has stable mild hydro and declined functional imaging and 1 was lost to follow-up. Mean time to spontaneous resolution was 10 mo. (± 9.2) and 15 mo. (± 16) in the Ureteroscopy and PCNL groups respectively. Conclusions Our data showing a 2.4% rate of hydronephrosis following ureteroscopy is consistent with previously reported data (0 - 4.8% in 7 published series). We now add to the literature an assessment of the rate of silent hydronephrosis following PCNL of 5.7%, which is similar to that rate observed after ureteroscopy suggesting routine imaging following PCNL to screen for silent obstruction is warranted. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e492 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Lawrence Dagrosa More articles by this author Rachel Moses More articles by this author Vernon Pais More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...