816 Are urological patients at increased risks of developing haemostatic complications following shock wave lithotripsy (SWL) for solitary unilateral kidney stones?

Hughes, Stephen; Thomas-Wright, Samantha Jayne; Banwell, Joseph; Mushtaq, Sohail; Williams, Ronald J.; Abdulmajed, Mohamed Ismat; Shergill, Iqbal

doi:10.1016/s1569-9056(14)60804-6

Cited by 2 publications

(2 citation statements)

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“…Specifically, following TURBT, changes to selective biological markers, such as total protein, albumin, alkaline phosphatase, bilirubin, total leukocytes, neutrophils, haemoglobin, erythrocytes, fibrinogen, and plasma viscosity were reported. Our group, BCUHB North Wales Clinical Research Centre (UK), have recently reported of similar changes to several routine blood parameters following shock wave lithotripsy (SWL) and flexible ureterorenoscopy (FURS), for the treatment of kidney stones (13,14,16,17). Collectively, these changes in various blood parameters may therefore play an intrinsic role toward the 'normal' response following routine urological procedures.…”

Section: Discussionmentioning

confidence: 86%

The Effect of Trans-urethral Resection of the Bladder Tumour (TURBT) on Routine Haematological and Biochemical Blood Tests: A Clinical-pilot Observational Study

Hughes

Lamb

Moyes³

et al. 2020

Int. J Biomed Sci.

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Background: Bladder Cancer remains a major health burden, with over 10,000 new cases diagnosed annually in the UK. Around 80% of all cases are diagnosed as Non-Muscle Invasive Bladder Cancer (NMIBC), and 75% of patients have cancer recurrence and progression within 10 years. Patients with NMIBC are treated by Trans-Urethral Resection of the Bladder Tumour (TURBT), with approximately 8% of patients subsequently developing post-operative complications, such as bleeding, pain and infection. Currently, there is limited literature on the ‘normal’ pathophysiological response to TURBT for NMIBC, and predictors for post-operative complications. The aim of this clinical-pilot observational study was to evaluate changes in routine blood tests following TURBT. The objectives were to identify the ‘normal’ pathophysiological response after TURBT. Methods: 34 consecutive patients aged between 57–94 years (median age: 72), scheduled for TURBT were recruited after written informed consent. Venous blood samples were collected from patients pre operatively (baseline), and post operatively at the following time points; 30 minutes, 120 minutes and 240 minutes post-operatively. Results: Following TURBT, significant decreases were seen in several haematological and biochemical markers: haemoglobin (p<0.01), platelets (p<0.01), erythrocytes (p<0.01), haematocrit (p<0.01), plasma viscosity (p=0.002) activated partial thromboplastin time (p= 0.004), fibrinogen (p<0.01), potassium (p<0.01), globulin (p=0.047), alkaline phosphatase (p=0.001), and urea (p=0.001). Furthermore, significant increases were observed in numerous haematological and biochemical parameters: leukocytes (p=0.049), neutrophil count (p=0.022), prothrombin (p=0.014), bilirubin (p= 0.004), and alanine transaminase (p=0.004). Conclusion: Significant changes to several routine blood tests occur following TURBT, and in general, it appeared that the most noticeable changes occurred between 30 and 120 minutes post-operatively. This clinical-pilot study may therefore provide a sound platform to undertake larger studies, to fully establish the effect of TURBT on routine blood tests, and could ultimately provide valuable information for doctors that may help with the clinical management of patients.

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Section: Discussionmentioning

confidence: 86%

The Effect of Trans-urethral Resection of the Bladder Tumour (TURBT) on Routine Haematological and Biochemical Blood Tests: A Clinical-pilot Observational Study

Hughes

Lamb

Moyes³

et al. 2020

Int. J Biomed Sci.

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“…We have previously reported on the safety and efficacy and changes to routine and novel biomarkers following various urological and other surgical procedures [25][26][27][28][29][30][31][32]. The present study intends to build on previous work and to consider the association between various physiological, surgical and clinical outcome measures following FURS.…”

Section: Introductionmentioning

confidence: 96%

Pre- and peri-operative clinical information, physiological observations and outcome measures following flexible ureterorenoscopy (FURS), for the treatment of kidney stones. A single-centre observational clinical pilot-study in 51 patients

et al. 2022

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Background Kidney stone disease contributes to a significant proportion of routine urological practice and remains a common cause of worldwide morbidity. The main aim of this clinical-pilot study was to investigate the effect of flexible ureterorenoscopy (FURS) on pre- and peri-operative clinical information, physiological observations and outcome measures. Methods Included were 51 patients (31 males, 20 females), who underwent elective FURS, for the treatment of kidney stones. Pre-operative and peri-operative clinical information, and post-operative physiological observations and outcome measures were collected using a standard case report form. Pre-operative clinical information included age, gender, BMI, previous history of stone formation and hypertension. Pre-operative stone information included the size (mm), Hounsfield units (HU), laterality and intra-renal anatomical location. Peri-operative surgical details included surgical time in minutes; Laser use; Duration and energy of laser; and post-operative stenting. The physiological outcomes measured included systolic and diastolic blood pressure (mmHg), Likert pain score, temperature, heart rate (bpm) and respiration rate (bpm). Following initial descriptive analysis, a series of Pearson’s correlation coefficient tests were performed to investigate the relationship between surgical factors other variable factors. Results A series of significant, positive correlations were observed between; age and surgical time (p = 0.014, r = 0.373); stone size and Hounsfield unit (p = 0.029, r = 0.406); surgical time and duration of laser (p < 0.001, r = 0.702); surgical time and BMI (p = 0.035, r = 0.322); baseline heart rate and Hounsfield unit (p = 0.026, r = − 0.414); base line heart rate and BMI (p = 0.030, r = 0.307).; heart rate at 120-min post FURS and age (p = 0.038, r = − 0.308); baseline pain score and BMI (p = 0.010, r = 0.361); baseline respiration rate and BMI (p = 0.037, r = 0.296); respiration rate at 240-min post FURS and BMI (p = 0.038, r = 0.329); respiration rate at 120 min post FURS and age (p = 0.022, r = − 0.330). Four patients developed post-operative complications (3—UTIs with urinary retention, 1–urosepsis). Conclusions We report that following FURS there is an association between various physiological, clinical and surgical parameters. Although these correlations are weak, they warrant further investigation as these may be linked with untoward complications, such as infection that can occur following FURS. This data, however, will need to be validated and reproduced in larger multi-centre studies.

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816 Are urological patients at increased risks of developing haemostatic complications following shock wave lithotripsy (SWL) for solitary unilateral kidney stones?

Cited by 2 publications

References 0 publications

The Effect of Trans-urethral Resection of the Bladder Tumour (TURBT) on Routine Haematological and Biochemical Blood Tests: A Clinical-pilot Observational Study

The Effect of Trans-urethral Resection of the Bladder Tumour (TURBT) on Routine Haematological and Biochemical Blood Tests: A Clinical-pilot Observational Study

Pre- and peri-operative clinical information, physiological observations and outcome measures following flexible ureterorenoscopy (FURS), for the treatment of kidney stones. A single-centre observational clinical pilot-study in 51 patients

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