Materials and Methods: Data from 6 centers were collected retrospectively from members of the Endourology Disease Group for Excellence in 232 patients who had residual fragments after ureteroscopy between 2006 and 2013. Patients with fragment(s) of any size on imaging within 12 months were eligible. The primary outcome measured was stone events, and secondary outcomes included stone growth, stone passage, re-intervention and complications.
Results: Of the 232 subjects with fragments 131 (56%) required no further intervention and remained asymptomatic, 34 (15%) experienced complications requiring no intervention and 67 (29%) required intervention, ie the primary outcome stone event rate was 44%. Fragments larger than 4 mm were more likely to grow with time (p <0.001) and were associated with more complications (p¼0.039). Fragments larger than 2 mm were more likely to grow (p <0.001) but were not associated with complications or re-intervention. Re-intervention was predictable based on fragment size (p¼0.017). In a multivariable logistic regression model there was no significant difference between the techniques of dusting stones or basket extraction.
Conclusions: This study suggests that fragment size larger than 4 mm after ureteroscopy is associated with significantly higher rates of stone growth, complications and the need for re-intervention. Ensuring complete stone-free status is the most effective strategy to reduce stone events after ureteroscopy.
Ben H. Chew,*,† Hilary L. Brotherhood,‡ Roger L. Sur,‡ An Qi Wang,‡ Bodo E. Knudsen,‡ Courtney Yong,‡ Tracy Marien,‡ Nicole L. Miller,§ Amy E. Krambeck,‡ Cameron Charchenko‡ and Mitchell R. Humphreysk
From the University of British Columbia, Vancouver, British Columbia, Canada (BHC, HLB), University of California San Diego, La Jolla, California (RLS, AQW), Ohio State University, Columbus, Ohio (BEK, CY), Vanderbilt University, Nashville, Tennessee (TM, NLM), Mayo Clinic, Rochester, Minnesota (AEK, CC), and Mayo Clinic Arizona, Phoenix, Arizona (MRH)
Go "Beyond the Abstract" - Read an article written by the authors for UroToday.com
Ben H. Chew,*,† Hilary L. Brotherhood,‡ Roger L. Sur,‡ An Qi Wang,‡ Bodo E. Knudsen,‡ Courtney Yong,‡ Tracy Marien,‡ Nicole L. Miller,§ Amy E. Krambeck,‡ Cameron Charchenko‡ and Mitchell R. Humphreysk
From the University of British Columbia, Vancouver, British Columbia, Canada (BHC, HLB), University of California San Diego, La Jolla, California (RLS, AQW), Ohio State University, Columbus, Ohio (BEK, CY), Vanderbilt University, Nashville, Tennessee (TM, NLM), Mayo Clinic, Rochester, Minnesota (AEK, CC), and Mayo Clinic Arizona, Phoenix, Arizona (MRH)
Go "Beyond the Abstract" - Read an article written by the authors for UroToday.com