A population-based retrospective cohort study analyzing contemporary trends in the surgical management of urinary stone disease in adults

Golomb, Dor; Davé, Sumit; Berto, Fernanda Gabrigna; McClure, J. Andrew; Welk, Blayne; Bjazevic, Jennifer; Razvi, Hassan

doi:10.5489/cuaj.7474

Cited by 8 publications

(10 citation statements)

References 20 publications

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“…The reported incidence of urolithiasis in males is estimated to be two-fold higher than females, 11 but recent data has shown a narrowing of the gender gap. 7,8 In our study we investigated the effect of gender on the presentation and outcome of patients visiting the ED, that were found to have ureteral stones on CT. We report in our study that female presentation at the ED with ureteral stones was associated with elevated body temperature, pulse rate, nausea, vomiting elevated serum CRP, and a higher incidence of positive urine cultures. Males admitted were found to have increased serum creatinine.…”

Section: Discussionmentioning

confidence: 99%

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Effect of gender on presentation and outcome of renal colic

Golomb¹,

Shemesh²,

Goldberg

et al. 2023

Urologia

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Objectives: To examine gender-related differences in the presentation, management, and outcomes of patients admitted to the emergency department ED with ureteral stones. Methods: Retrospective analysis of all patients admitted to the ED at our institution, found to have a ureteral stone on CT. Clinical, laboratory, imaging parameters, and outcomes were collected. Results: 778 patients were admitted with ureteral stones between January 2018 and December 2020. 78% ( n = 609) were males and 22% ( n = 169) were females. The mean ages were 49.4 (SD 14.4) and 51.6 (SD 15.7) in males and females, respectively ( p = 0.08). Female patients presented with a higher body temperature ( p = 0.01), pulse rate ( p < 0.0001), nausea and vomiting ( p < 0.0001), elevated serum C-reactive protein (CRP) ( p = 0.002) compared to males. The prevalence of elevated serum creatinine was higher in males ( p < 0.0001). Alpha-blockers were recommended on discharge in 54.8% (334) of males, compared to only 29.6% (50) of females ( p < 0.0001). Spontaneous stone expulsion was significantly higher in males compared to females ( p = 0.01). Conclusions: Our results demonstrate that gender does effect presentation and outcome of patients presenting with renal colic. Females were found to have elevated infectious parameters, more nausea and vomiting and a higher incidence of positive urine cultures. Males admitted to the ED were found to have significantly higher serum creatinine levels. Medical expulsive therapy (MET) with alpha-blockers was prescribed significantly less in female patients, which may have resulted in a lower spontaneous stone expulsion rate.

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Section: Discussionmentioning

confidence: 99%

“…4 Males have a two-fold higher incidence of urolithiasis than females, 5,6 although, recent studies reported a narrowing of the gender gap. 7,8…”

Section: Introductionmentioning

confidence: 99%

Effect of gender on presentation and outcome of renal colic

Golomb¹,

Shemesh²,

Goldberg

et al. 2023

Urologia

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“…4 Males have an estimated two-fold higher incidence of urinary calculi than females, 5 although recent data has shown a decrease in this reported difference between males and females. 6,7 The incidence of renal colic has been reported to increase in the different age groups, as reported in a study by Fwu et al 4 In their study they investigated ED visits due to renal colic, over a 17-year period.…”

Section: Introductionmentioning

confidence: 92%

“…They noted an increase in ED admission rates in each age group. A recent study from Ontario, Canada, 6 reported that between the years 2002 and 2019, for every increase by 1% in the population size, there was a 2.6% rise in stone related surgical procedures.…”

Section: Effect Of Age On Presentation and Outcome In Renal Colicmentioning

confidence: 99%

Effect of age on presentation and outcome in renal colic

Golomb¹,

Shemesh²,

Goldberg

et al. 2022

Urologia

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Objectives: To examine the age-related differences in the presentation, management, and outcomes of patients admitted to the emergency department (ED) with ureteral stones. Patients and methods: A retrospective analysis of all patients who visited the ED at a single institution that were found to have a ureteral stone on CT. Clinical, laboratory, and imaging parameters were collected, including outcomes. Patients were subdivided into age groups: 18–30, 31–50, 51–70, and >70 years. Results: Between January 2018 and December 2020, 778 patients were admitted to the ED with a ureteral stone. About 78% (609) were males and 22% (169) were females. The mean ages were 49.4 (SD 14.4) and 51.6 (SD 15.7) in males and females, respectively ( p = 0.08). Patients in the 36–50 age group, had significantly higher visual analogue scale (VAS) scores ( p < 0.0001). Patients older than 70 years old presented with significantly higher serum creatinine levels ( p < 0.0001), C-reactive protein (CRP) ( p < 0.001) and leukocyte levels ( p = 0.002). These patients were also found to have significantly larger stones (mean size of 6.2 mm (SD 4.8) ( p < 0.0001)) and underwent percutaneous nephrolithotripsy (PCNL) in significantly higher numbers (56.3% vs 43.8%, ( p < 0.0001)). Less than half of the patients older than 50 years were given medical expulsive therapy (MET) with alpha-blockers, compared to more than 50% in the other age groups ( p = 0.002). Spontaneous stone expulsion was noted in 70.2% of the 18–35-year group, 62.4% of the 36–50-year-old group, 51.8% of the 51–70-year-old group, and 37% of the >70-year-old group ( p < 0.0001). The ED re-admission rates at 7 and 30 days were not significantly different among all age groups. Conclusions: Our data suggests that older patients presented with larger stones, elevated inflammatory markers and creatinine and were more likely to require surgical intervention. The spontaneous stone expulsion rate was inversely associated with age.

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“…Most of KSD patients (or stone formers) are asymptomatic and may require no specific treatment [2] , [3] . In complicated KSD, extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PNL), ureteroscopy (URS) and other surgical procedures are the common therapeutic procedures to remove kidney stones [4] , [5] , [6] . Nevertheless, there is a high recurrence rate following the stone removal [7] , [8] , [9] .…”

Section: Introductionmentioning

confidence: 99%