Age-related prevalence of diabetes mellitus, cardiovascular disease and anticoagulation therapy use in a urolithiasis population and their effect on outcomes: the Clinical Research Office of the Endourological Society Ureteroscopy Global Study

Daels, Francisco Pedro Juan; Gaižauskas, Andrius; Rioja, Jorge; Varshney, A. K.; Erkan, Erkan; Özgök, Yaşar; Melekos, Michael D.; Rosette, Jean J.M.C.H. de la

doi:10.1007/s00345-014-1382-6

Cited by 29 publications

(12 citation statements)

References 17 publications

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“…Since the numbers are small, larger studies are needed. Studies have indicated that the risk of complications does not increase with age [29]. In our study the risk of complications seems to increase with age and the ROC curve analysis indicates that a possible cut off at 65 years might be recommended.…”

Section: Discussionsupporting

confidence: 54%

Ureteroscopy: a population based study of clinical complications and possible risk factors for stone surgery

Wagenius

Rydberg

Popiołek

et al. 2019

Cent european J Urol

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IntroductionThe aim of this study was to describe the complications of ureteroscopy (URS) and to investigate whether performing URS outside normal working hours leads to increased risk for clinically significant complications.Material and methodsA cohort of 486 consecutive patients treated with URS, with a total of 567 sessions between 2009 and 2015 at Helsingborg/Ängelholm Hospital, Sweden, was analyzed. Outcome was complications within 14 days after URS treatment.ResultsWe found no increased risk of complications related to URS performed outside normal working hours. Stone-free rate (SFR) in the distal third of the ureter was 95.2% (315/331), in the middle ureter 92.8% (90/97), in the proximal ureter 84.0% (63/75) and 69.0% (40/58) in renal pelvis. The overall complication rate was 10.6% (n = 60). None of the potential risk factors for complications showed any significance when adjusted for age and gender. We found an inverse relationship between stenting and SFR (p = 0.002). The most common preoperatively cultured bacteria was Escherichia coli. With adequate antibiotics, there was no increased risk of complications. There was an increased risk of complications after URS related to age, but not with gender.ConclusionsURS in modern setting provides excellent results with adequate SFR and low morbidity. Time of day, the presence of urological specialized operating nurses did not affect the risk of complications and we found no other significant risk factors for complications. Escherichia coli was the most commonly found bacteria in preoperative cultures. The risk of complications increases with age. For patients >65 years old, this should be considered in preoperative counseling.

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Section: Discussionsupporting

confidence: 54%

Ureteroscopy: a population based study of clinical complications and possible risk factors for stone surgery

Wagenius

Rydberg

Popiołek

et al. 2019

Cent european J Urol

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“…is associated with older age and other chronic diseases. Daels analyzes the data from the CROES database of a multicentre study of Endourological Society, which included 114 hospitals from 32 countries and 11885 patients with ureteroscopic lithotripsy, concluded in his paper that the risk of complications is greater in elderly patients suffering from associated diseases (20). It has been found that there is a significant risk of complications in patients suffering from cardiovascular disease, diabetes, obesity and patients using anticoagulant therapy.…”

Section: Discussionmentioning

confidence: 99%

Possible risk factors for postoperative urinary tract infection following ureteroscopic lithotripsy

et al. 2020

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Background/Aim.Ureteroscopic lithotripsy is today a safe method of endoscopic destruction of stone in the kidney and ureter with a small number of complications of which the most common is postoperative urinary tract infection. Risk factors for the occurrence of urinary tract infection after the ureteroscopic destruction of stones in the ureter and kidney in the previous studies are not clearly defined. Methods. The study included 389 patients with ureteroscopic lithotripsy and possible risk factors were analyzed: age of the patient, sex, diabetes, presence, and degree of hydronephrosis, stone size, stone localization, wear of ureteral JJ stent and percutaneous nephrostomy catheter, type of surgical procedure and the duration of the operation. The frequency of postoperative urinary tract infection was statistically analyzed in relation to the possible risk factors. Results. 10% of patients had postoperative urinary tract infection. The higher incidence of postoperative urinary tract infection was found in patients with diabetes (X 2 =22.918; p<0.001), who before surgery carried a ureteral JJ stent (X 2 =4.620; p=0.040) and percutaneous nephrostomy catheter (X 2 =8.240; p=0.004), which had a larger stone (Z=-3.301; p=0.001), and in patients whose surgery lasted longer (t=4.261; p<0.001). Discussion. The risk of postoperative urinary tract infection following ureteroscopic lithotripsy is not negligible and is not clearly defined in the existing literature. Many authors examined risk factors for the emergence of postoperative urinary tract infections after ureteroscopic lithotripsy with different results and frequency. The frequency of postoperative urinary infection and risk factors for its emergence in our study are in line with the results of studies by other authors. Conclusion. Patients with diabetes, who preoperatively carried JJ stent or a percutaneous nephrostomy catheter, who had large stones and in which the operating time is longer have a greater risk of developing postoperative urinary tract infection. Accordingly, the importance of identifying these patients in the preparation for ureteroscopic lithotripsy contributes to the appropriate preoperative preparation and decreases the frequency of postoperative urinary tract infection to a minimum.

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“…The global study published in 2014 by the Clinical Research Office of the Endourological Society states that ureteroscopy could be safely used on patients with high comorbidities [19]. Although the comorbidity rate in the study was high and 4 patients used anticoagulants, only one patient manifested complications more severe than grade 2.…”

Section: Discussionmentioning

confidence: 99%

Retrograde intrarenal surgery and percutaneous nephrolithotomy for the treatment of stones in the horseshoe kidney; what are the advantages and disadvantages compared to each other?

Kartal¹,

Çakıcı

Selmï

et al. 2019

Cent european J Urol

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Introduction Kidney stones occur more frequently in patients with a horseshoe kidney (HSK) anomaly. Abnormal anatomy may make the stone removal procedures more difficult. Therefore we aimed to evaluate and compare retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL) for the treatment of renal stones in the HSK anomaly. Material and methods In this descriptive study, patients with HSK anomaly who underwent RIRS and PCNL procedures were retrospectively evaluated. Demographic and renal stone characteristics, success and complications associated with the surgical methods were compared across patients. Results A total of 49 patients were evaluated, 28 underwent RIRS and 21 underwent PCNL. No differences were determined between the groups concerning the demographics of patients and stone characteristics. A single session and final stone-free rate was 71.4% and 85.7% in RIRS, 81% and 90.5% in PCNL (both p ≥0.05). However, RIRS had more re-treatment rate, while its mean length of hospital stay was shorter than PCNL (p = 0.035, p = 0.001). While no differences were detected between the associated complication rates, more of the complications encountered in the PCNL group were of a serious nature. Conclusions In the HSK anomaly, renal stones can be treated with RIRS and PCNL procedures with high success. With its minimal morbidity, low complication rates and the minor character of the associated complications, the RIRS procedure can sometimes be preferred to avoid complications related to PCNL in HSK anomaly with big sized kidney stones.

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Age-related prevalence of diabetes mellitus, cardiovascular disease and anticoagulation therapy use in a urolithiasis population and their effect on outcomes: the Clinical Research Office of the Endourological Society Ureteroscopy Global Study

Abstract: This is the first study confirming in a global population that URS can effectively and safely be performed in a population with high comorbidity. The risk of a complication was highest among elderly patients presenting with comorbidities.

Cited by 29 publications

References 17 publications

Ureteroscopy: a population based study of clinical complications and possible risk factors for stone surgery

Ureteroscopy: a population based study of clinical complications and possible risk factors for stone surgery

Possible risk factors for postoperative urinary tract infection following ureteroscopic lithotripsy

Retrograde intrarenal surgery and percutaneous nephrolithotomy for the treatment of stones in the horseshoe kidney; what are the advantages and disadvantages compared to each other?

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