The surgical management of upper tract stone disease among spinal cord-injured patients

Welk, Blayne; Shariff, Salimah Z.; Ordon, Michael; Craven, B. Catharine; Herschorn, Sender; Garg, Amit X.

doi:10.1038/sc.2013.15

Cited by 12 publications

(14 citation statements)

References 19 publications

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“…PNL is a proper treatment modality for patients with a large stone burden and staghorn renal calculi, as commonly found in SCI patients. The success rate for a single PNL session is between 53.8 and 62 % [7][8][9][10][11][12]. However, additional PNL sessions are reported to increase the stone-free rate up to 96 % [8].…”

Section: Discussionmentioning

confidence: 87%

“…Its minimally invasive nature and reduced risk of complications are the main advantages compared to PNL. The use of URS in SCI patients is reported by two recently published studies [6,7]. Welk et al [7] evaluated 5121 patients who had experienced an SCI in the previous 9 years and investigated surgical interventions for kidney stones.…”

Section: Discussionmentioning

confidence: 96%

“…As surgeons gain experience, it can be used for even the most challenging cases. The literature contains limited references to SCI patients treated with PNL [7][8][9][10][11][12]. PNL is a proper treatment modality for patients with a large stone burden and staghorn renal calculi, as commonly found in SCI patients.…”

Section: Discussionmentioning

confidence: 98%

“…SCI patients represent a unique group that is associated with multiple co-morbidities, and increased risk of mortality and postoperative complication rate [1][2][3][4][5][6][7][8][9][10][11][12]14]. The most serious urologic complications of SCI and neurogenic bladder dysfunction include the formation of vesicoureteral reflux and hydronephrosis, renal failure, urolithiasis, UTI, bladder cancer, and sexual dysfunction [15].…”

Section: Discussionmentioning

confidence: 99%

“…The main factors complicating treatment of urolithiasis in SCI patients include (1) an increased risk of urinary tract infection (UTI) and urosepsis related to neurogenic bladder dysfunction, (2) patient positioning difficulties related to contracture of the extremities, and (3) risks secondary to accompanying co-morbidities. The literature contains a limited number of studies presenting the outcomes of ureteroscopy (URS) [6,7] or percutaneous nephrolithotomy (PNL) [7][8][9][10][11][12] in this specific patient group.…”

Section: Introductionmentioning

confidence: 99%

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Flexible ureteroscopic laser lithotripsy for upper urinary tract stone disease in patients with spinal cord injury

2015

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The objective of this study is to present the outcomes of flexible ureteroscopic laser lithotripsy (URS) for upper urinary tract stone disease in spinal cord injury (SCI) patients performed by a single surgeon. A retrospective analysis was performed for SCI patients treated with flexible URS for proximal ureter and kidney stone disease by a single surgeon between 2003 and 2013. Patient characteristics, operative outcomes, metabolic evaluation, and stone analyses were assessed in detail. A total of 27 URS procedures were performed for urolithiasis in 21 renal units of 19 patients. The mean age was 52.1 ± 15.6 years (16-72) and mean BMI was 29.2 ± 7.3 kg/m(2) (20-45.7). Etiology of SCI was trauma (n: 10), multiple sclerosis (n: 6), cerebrovascular accident (n: 1), or undetermined (n: 2). The mean stone size was 15.9 ± 8.6 (6-40) mm. In the 27 URS procedures, stones were located in the ureter (n: 5), the kidney (n: 14), and both areas (n: 8). Mean hospitalization time was 2.0 ± 2.4 (0-10) days. Postoperative complications were observed in 6 cases (22.2%). Three major complications included urosepsis (n: 1) and respiratory failure (n: 2), that were observed postoperatively and required admission to the intensive care unit. The 2 minor complications were hypotension, fever and UTI, and required medical treatment. Fourteen (66.6%) of the 21 renal units were stone free. Calcium phosphate carbonate (n: 9) and struvite (n: 5) were the primary stone compositions detected. Hypocitraturia (n: 6), hypercalciuria (n: 5), hypernaturia (n: 5), hyperoxaluria (n: 4), and hyperuricosuria (n: 1) were common abnormalities in 24-h urine analysis. Ureteroscopic laser lithotripsy can be an effective treatment modality for SCI patients with upper urinary tract calculi.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Flexible ureteroscopic laser lithotripsy for upper urinary tract stone disease in patients with spinal cord injury

2015

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PCNL in neurogenic bladder: A challenging population for both clinical management and analysis

et al. 2023

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ObjectivesTo review the management of patients with neurogenic bladder undergoing percutaneous nephrolithotomy (PCNL) at our institution with the aim of assessing peri‐operative morbidity.Subjects/patients and methodsWe conducted a retrospective review of all neurogenic bladder patients who underwent PCNL at our hospital in the last decade with the aim of assessing peri‐operative morbidity.ResultsA total of 298 PCNL were performed during the study period of which 58 were in patients with a neurogenic bladder or urinary diversion, 33 of which were in SCI patients. Preoperative demographic and stone characteristics, intraoperative data and postoperative length of stay and complications are summarised in table form.ConclusionPCNL remains an acceptably safe and efficacious treatment for upper tract stone disease in patients with neurogenic bladders and will continue to have a valuable role where SCI prevents alternative approaches such as ureteroscopy.

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Outcomes of renal calculi in patients with spinal cord injury

Lane

Roberts

Mann

et al. 2019

Neurourology and Urodynamics

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Aims: Patients with spinal cord injury (SCI) are at risk of developing renal calculi. This study describes the management of renal calculi among patients with SCI with attention to factors influencing surgical management vs observation. Methods: This retrospective, cohort study identified patients with SCI and renal calculi between 2009 to 2016 from an institutional neurogenic bladder database and detailed the management of their stones. A stone episode was defined as radiographic evidence of new calculi.Results: Of 205 patients with SCI, 34 had renal stones, for a prevalence of 17%. The mean age was 50 years (range 22,77) and most had cervical SCI (n = 22,

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The surgical management of upper tract stone disease among spinal cord-injured patients

Cited by 12 publications

References 19 publications

Flexible ureteroscopic laser lithotripsy for upper urinary tract stone disease in patients with spinal cord injury

Flexible ureteroscopic laser lithotripsy for upper urinary tract stone disease in patients with spinal cord injury

PCNL in neurogenic bladder: A challenging population for both clinical management and analysis

Outcomes of renal calculi in patients with spinal cord injury

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