Obesity is a significant epidemic, with far reaching health implications. It is estimated that >30% of the adult US population are obese and the prevalence rates will continue to increase rapidly. 1 Natarajan V. Master V. Ogan K. Effects of obesity and weight loss in patients with nononcological urological disease. J Urol. 2009; 181: 2424-2429 Abstract Full Text Full Text PDF PubMed Scopus (13) Google Scholar Obesity is associated with heart disease, hypertension, sleep apnea, and type II diabetes. Salient to urologists is the association of renal lithiasis and obesity. Bariatric surgery as a means of surgical treatment of obesity has become increasingly popular, with an estimated 177 600 surgeries performed in the United States in 2006. 2 American Society for Metabolic and Bariatric Surgery http://www.asbs.org Google Scholar Asplin and Coe 3 Asplin J.R. Coe Fl Hyperoxaluria in kidney stone formers treated with modern bariatric surgery. J Urol. 2007; 177: 565 Abstract Full Text Full Text PDF PubMed Scopus (135) Google Scholar demonstrated that the most common bariatric surgery, the Roux-en-Y gastric bypass (RYGB), results in significant hyperoxaluria and supersaturation of calcium oxalate as early as 3 months postprocedure. Matlaga et al 4 Matlaga B.R. Shore A.D. Magnuson T. et al. Effect of gastric bypass surgery on kidney stone disease. J Urol. 2009; 181: 2573-2577 Abstract Full Text Full Text PDF PubMed Scopus (107) Google Scholar recently reported that RYGB surgery results in a higher incidence of renal lithiasis as compared with a cohort of control subjects, with BMIs >35 and matched on the basis of age, gender, and comorbid conditions. Are obese patients contemplating weight control surgery “caught between a rock and a hard place”? This study appears to offer some promise. The authors demonstrate that gastric banding (GB), a surgical alternate to the RYGB, is not associated with an increased risk of renal lithiasis or kidney stone surgery. They compared a cohort of patients who underwent GB with a control group of patients having BMI >35 and matched by age, gender, and comorbid conditions. The addition of a third cohort who underwent the more popular RYGB may have added to the study. Although the finding of no apparent increased risk of lithiasis associated with the GB technique is encouraging, this positive finding should be tempered because of the relatively short-term follow-up in this study. Nonetheless, the authors should be commended for addressing the risk of lithiasis in patients undergoing weight-reduction surgery. The positive findings of this study should encourage further investigation into the metabolic association of renal lithiasis and the different methods of bariatric surgery. ReplyUrologyVol. 74Issue 4PreviewIn light of the obesity epidemic, which threatens to redefine the nature of medical care, surgical procedures that can bring about significant and lasting weight loss will continue to increase at a fast rate. In the short term, and unlike the Roux-en-Y gastric bypass, gastric banding does not appear to be associated with an increased risk for kidney stone disease or kidney stone surgery. However, long-term studies are imperative to confirm these encouraging findings. Equally helpful will be prospective studies that evaluate changes in urinary metabolic risk factors following restrictive surgical procedures such as gastric banding. Full-Text PDF The Effect of Gastric Banding on Kidney Stone DiseaseUrologyVol. 74Issue 4PreviewTo evaluate the likelihood of being diagnosed with, or treated for, an upper urinary tract calculus after gastric banding. Bariatric surgical procedures are being increasingly utilized in the treatment of patients with morbid obesity. Certain malabsorptive bariatric procedures have been associated with an increased risk for kidney stone formation. However, the kidney stone risk of gastric banding, a restrictive bariatric procedure, is unknown. Full-Text PDF