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Ungerer GN, Winoker JS, Healy KA, Shah O, Koo K. Mobile and eHealth technologies in the management and prevention of nephrolithiasis: A systematic review. Actas Urol Esp 2024; 48:25-41. [PMID: 37364768 DOI: 10.1016/j.acuroe.2023.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 04/19/2023] [Indexed: 06/28/2023]
Abstract
INTRODUCTION Kidney stone disease (KSD) is a common urological condition that often requires long-term care. Mobile health (mHealth) and eHealth technologies have the potential to enhance chronic disease management and behavioral change. To assess opportunities to apply these tools to improve KSD treatment and prevention, we aimed to assess current evidence on the use, benefits, and limitations of mHealth and eHealth in KSD. METHODS We performed a systematic review of primary research studies of mHealth and eHealth in the evaluation and management of KSD. Two independent researchers screened citations by title and abstract for relevance, then full-text review was performed for descriptive summary of the studies. RESULTS A total of 37 articles were included for analysis. Primary domains of evidence included: 1) "smart" water bottles and mobile-device apps for tracking fluid consumption, which showed increased intake in most studies; 2) ureteral stent tracking platforms, which improved the rate of long-term retained stents; 3) virtual stone clinics, which have been suggested to increase access, lower costs, and have satisfactory outcomes; 4) smartphone-based endoscopy platforms, which offered cost-effective image quality in resource-limited settings; 5) patient information about KSD online, which was typically characterized as poor quality and/or accuracy, particularly on YouTube. Most studies were proof-of-concept or single-arm intervention designs, with limited assessment of effectiveness or long-term clinical outcomes. CONCLUSIONS Mobile and eHealth technologies have significant real-world applications to KSD prevention, intervention, and patient education. A lack of rigorous effectiveness studies currently limits evidence-based conclusions and incorporation in clinical guidelines.
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Affiliation(s)
- G N Ungerer
- Department of Urology, Mayo Clinic, Rochester, MN, USA
| | - J S Winoker
- Smith Institute for Urology at Lenox Hill, Northwell Health, New York, NY, USA
| | - K A Healy
- Department of Urology, Columbia University Irving Medical Center, New York, NY, USA
| | - O Shah
- Department of Urology, Columbia University Irving Medical Center, New York, NY, USA
| | - K Koo
- Department of Urology, Mayo Clinic, Rochester, MN, USA.
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Karaaslan M, Olcucuoglu E, Kurtbeyoglu S, Tonyali S, Yilmaz M, Odabas O. Erector spinae plane block prior to extracorporeal shock wave lithotripsy decreases fluoroscopy time and promise a comfortable procedure for renal stones: A prospective randomized study. Actas Urol Esp 2023; 47:566-572. [PMID: 37084807 DOI: 10.1016/j.acuroe.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/17/2023] [Accepted: 02/20/2023] [Indexed: 04/23/2023]
Abstract
INTRODUCTION AND OBJECTIVES To compare the efficacy of erector spinae plane block (ESPB) and intramuscular (i.m.) diclofenac sodium in regard to pain management and impact on stone-free status in patients undergoing SWL. PATIENTS AND MATERIALS The study included patients who underwent SWL for kidney stones in our institution. The patients were randomly assigned to the ESPB (Group 1: n = 31) and i.m. 75 mg diclofenac sodium (Group 2: n = 30) groups. The demographic data of the patients, fluoroscopy time during SWL, number of need of targeting, total shocks given, voltage, stone free rates (SFR), analgesy method, number of SWL sessions, VAS score, stone location, maximum stone size, stone volume and Hounsfield unit (HU) were also recorded. RESULTS A total of 61 patients were included the study. There was no statistically significant difference between the two groups according to stone size, volume and density, SWL duration, total shocks given, voltage, BMI, stone-free status and stone location. Fluoroscopy time and number of need for stone targeting were significantly lower in group 1 than group 2 (p = 0.002, p = 0.021, respectively). The VAS score was significantly lower for group 1 compared to group 2 (p < 0.001). CONCLUSIONS We observed that the VAS score was lower in the ESPB group compared to i.m. diclofenac sodium group and although it was not statistically significant, we achieved a higher rate of stone-free status in the first session in ESPB group. Most importantly, the patients in the ESPB group were exposed to less fluoroscopy and radiation.
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Affiliation(s)
- M Karaaslan
- Servicio de Urología, Hospital Estatal de Bingol, Bingol, Turkey.
| | - E Olcucuoglu
- Servicio de Urología, Universidad de Ciencias de la Salud, Hospital de la Ciudad de Ankara, Ankara, Turkey
| | - S Kurtbeyoglu
- Servicio de Anestesiología y Reanimación, Universidad de Ciencias de la Salud, Hospital Municipal de Ankara, Ankara, Turkey
| | - S Tonyali
- Facultad de Medicina, Universidad de Estambul, Servicio de Urología, Estambul, Turkey
| | - M Yilmaz
- Servicio de Urología, Centro Médico Universitario de Friburgo, Facultad de Medicina, Friburgo, Germany
| | - O Odabas
- Servicio de Urología, Universidad de Ciencias de la Salud, Hospital de la Ciudad de Ankara, Ankara, Turkey
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Culpan M, Acar HC, Akalin K, Cakici MC, Tufekci B, Gunduz N, Dogan MB, Yildirim A, Atis G. Are the current nomograms sufficient to predict shockwave lithotripsy outcomes? Actas Urol Esp 2022; 46:473-480. [PMID: 35803872 DOI: 10.1016/j.acuroe.2021.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 12/11/2021] [Indexed: 12/13/2022]
Abstract
INTRODUCTION AND OBJECTIVES To investigate factors affecting SWL outcomes, validate three current nomograms (Kim JK, Triple D and S3HoCKwave) and compare the predictive ability of the nomograms for SWL outcomes in upper urinary tract stones. PATIENTS AND METHODS Medical records of patients with renal and proximal ureteral stones treated with SWL between March 2013 and October 2020 were retrospectively reviewed. Factors affecting SWL success were analyzed with multivariate logistic regression analysis and the three predictive scoring systems compared with the area under the curve (AUC). RESULTS A total of 580 patients were included in our study. The overall stone free rate was 61% and 144/580 patients (24.8%) were stone free after one session. In multivariate logistic regression analysis, stone location at upper calyx (OR:2.988; 95%Cl: 1.350-6.612; p = 0.007), middle calyx (OR:3.036; 95%Cl: 1.472-6.258; p = 0.003), and lower calyx (OR:2.131; 95%Cl: 1.182-3.839; p = 0.012), as well as number of stones (OR:1.663; 95%Cl: 1.140-2.425; p = 0.008), maximum diameter of stone (OR:1.156; 95%Cl: 1.098-1.217; p < 0.001) and maximum Hounsfield Unit (OR:1.001; 95%Cl: 1.001-1.002; p < 0.001) were independent risk factors of SWL failure. The AUCs of the Kim JK, Triple D and S2HoCKwave scores for predicting SWL success were 0.678, 0.548, and 0.626 respectively. CONCLUSIONS Stone location, number, maximal diameter, and maximum HU were independent predictive factors for SWL outcome in the treatment of upper urinary tract stones. Current nomograms, "Kim JK nomogram", "Triple D score" and "S3HoCKwave score" can predict treatment success after SWL, but all of them have poor discrimination according to AUC analysis.
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Affiliation(s)
- M Culpan
- Department of Urology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey.
| | - H C Acar
- Department of Public Health, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - K Akalin
- Department of Urology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - M C Cakici
- Department of Urology, Istanbul Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey
| | - B Tufekci
- Department of Urology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - N Gunduz
- Department of Radiology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - M B Dogan
- Department of Radiology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - A Yildirim
- Department of Urology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - G Atis
- Department of Urology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
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Morgan K, Rees CD, Shahait M, Craighead C, Connelly ZM, Ahmed ME, Khater N. Urolithiasis in pregnancy: Advances in imaging modalities and evaluation of current trends in endourological approaches. Actas Urol Esp 2022; 46:259-267. [PMID: 35551890 DOI: 10.1016/j.acuroe.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 06/27/2021] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Given the challenges involved in diagnosis and treatment of pregnant women with urolithiasis, we aim to review the imaging modalities and current endourological management of these patients. MATERIALS AND METHODS We performed a review of the available literature on urolithiasis in pregnancy. This included evaluation, diagnostic imaging, and therapeutic options. The databases we searched from included Google Scholar and PubMed. A total of 346 abstracts were screened. After our inclusion/exclusion criteria were met, we were left with 42 sources: 18 retrospective studies, 10 reviews/meta-analyses, 8 sets of guidelines, 5 randomized control trials, and 1 prospective cohort. RESULTS We begin our review with the literature available on the safety and efficacy of imaging modalities in the surgical planning for urolithiasis in pregnant patients. This includes renal ultrasound, abdominal x-ray, computed tomography scan, and magnetic resonance imaging. While computed tomography may result in an added radiation exposure, with possible safety concerns, magnetic resonance imaging seems to be safer, however a less sensitive test. We next describe safety, efficacy, and outcomes of various surgical interventions for urolithiasis in pregnant patients. This encompasses ureteral stenting, percutaneous nephrostomy, ureteroscopy, extracorporeal shock wave lithotripsy, and percutaneous nephrolithotomy. Ureteroscopy is a safer approach, but percutaneous nephrolithotomy offers higher stone-free rates. Using an evidence-based approach, we propose an algorithm for management of the pregnant women with renal colic. CONCLUSION Management of the pregnant women with suspected urolithiasis is a unique challenge for healthcare providers. A multi-disciplinary approach should be taken to optimize outcomes through an evidence-based approach.
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Affiliation(s)
- K Morgan
- Department of Urology, Louisiana State University Health Sciences Center, Shreveport, USA
| | - C D Rees
- Louisiana State University Health Sciences Center, School of Medicine Shreveport, LA, USA
| | - M Shahait
- Department of Surgery, King Hussein Cancer Center, Amman, Jordan
| | - C Craighead
- Louisiana State University Health Sciences Center, School of Medicine Shreveport, LA, USA
| | - Z M Connelly
- Louisiana State University Health Sciences Center, School of Medicine Shreveport, LA, USA
| | - M E Ahmed
- Department of Urology, Mayo Clinic, Rochester, USA
| | - N Khater
- Department of Urology, Louisiana State University Health Sciences Center, Shreveport, USA.
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Cechinel-Zanchett CC, Bolda Mariano LN, Schlickmann F, Cechinel-Filho V, de Souza P. In vitro effects of two bioactive compounds, gallic acid and methyl gallate, on urolithiasis. Actas Urol Esp 2021; 45:604-8. [PMID: 34690102 DOI: 10.1016/j.acuroe.2020.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 09/22/2020] [Indexed: 11/22/2022]
Abstract
INTRODUCTION AND OBJECTIVES This study aimed to evaluate the role of two widely distributed natural phenolic compounds, gallic acid (GA) and methyl gallate (MG), in an in vitro model of urolithiasis, by using the methodology of calcium oxalate (CaOx) crystals formation, which is the most common type of urinary or kidney stones. MATERIAL AND METHODS The compounds GA and MG were subjected to anti-crystallization activities in different concentrations (0.003-0.03 mg/mL), and the quantity and morphology of crystals were determined by microscopy after 60 min. RESULTS GA inhibited about 44-57% of the total CaOx crystals formation, while MG inhibited about 48.35%, when compared to vehicle-exposed samples (distilled water; negative control group). GA and MG exposure inhibited monohydrate type calculi formation, which is considered the most common and harmful crystal category. The compounds also decreased absorbance, which in turn is related to reduced CaOx aggregation and precipitation. CONCLUSIONS Altogether, this study shows, for the first time, that GA and MG are promising compounds with antiurolithiatic properties, opening new perspectives for future in vivo evaluations of the potential of these compounds in the treatment and/or prevention of urinary or kidney stones.
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Cechinel-Zanchett CC, Bolda Mariano LN, Schlickmann F, Cechinel-Filho V, de Souza P. In vitro effects of 2 bioactive compounds, gallic acid and methyl gallate, on urolithiasis. Actas Urol Esp 2021; 45:S0210-4806(21)00093-0. [PMID: 34127284 DOI: 10.1016/j.acuro.2020.09.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 09/22/2020] [Indexed: 11/23/2022]
Abstract
INTRODUCTION AND OBJECTIVES This study aimed to evaluate the role of 2 widely distributed natural phenolic compounds, gallic acid (GA) and methyl gallate (MG), in an in vitro model of urolithiasis, by using the methodology of calcium oxalate crystals formation, which is the most common type of urinary or kidney stones. MATERIAL AND METHODS The compounds GA and MG were subjected to anti-crystallization activities in different concentrations (0.003-0.03mg/mL), and the quantity and morphology of crystals were determined by microscopy after 60min. RESULTS GA inhibited about 44-57% of the total calcium oxalate crystals formation, while MG inhibited about 48.35%, when compared to vehicle-exposed samples (distilled water; negative control group). GA and MG exposure inhibited monohydrate type calculi formation, which is considered the most common and harmful crystal category. The compounds also decreased absorbance, which in turn is related to reduced calcium oxalate crystals aggregation and precipitation. CONCLUSIONS Altogether, this study shows, for the first time, that GA and MG are promising compounds with antiurolithiatic properties, opening new perspectives for future in vivo evaluations of the potential of these compounds in the treatment and/or prevention of urinary or kidney stones.
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Affiliation(s)
- C C Cechinel-Zanchett
- Programa de Pós-graduação em Ciências Farmacêuticas, Núcleo de Investigações Químico-Farmacêuticas (NIQFAR), Universidade do Vale do Itajaí (UNIVALI), Itajaí, Santa Catarina, Brasil
| | - L N Bolda Mariano
- Programa de Pós-graduação em Ciências Farmacêuticas, Núcleo de Investigações Químico-Farmacêuticas (NIQFAR), Universidade do Vale do Itajaí (UNIVALI), Itajaí, Santa Catarina, Brasil
| | - F Schlickmann
- Programa de Pós-graduação em Ciências Farmacêuticas, Núcleo de Investigações Químico-Farmacêuticas (NIQFAR), Universidade do Vale do Itajaí (UNIVALI), Itajaí, Santa Catarina, Brasil
| | - V Cechinel-Filho
- Programa de Pós-graduação em Ciências Farmacêuticas, Núcleo de Investigações Químico-Farmacêuticas (NIQFAR), Universidade do Vale do Itajaí (UNIVALI), Itajaí, Santa Catarina, Brasil
| | - P de Souza
- Programa de Pós-graduação em Ciências Farmacêuticas, Núcleo de Investigações Químico-Farmacêuticas (NIQFAR), Universidade do Vale do Itajaí (UNIVALI), Itajaí, Santa Catarina, Brasil.
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Grases F, Costa-Bauza A. Urinary stone diagnosis. Morphologic and composition analysis. ARCH ESP UROL 2021; 74:35-48. [PMID: 33459620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Analysis of urinary stones is an essential step in establishing the diagnosis and treatment of the stone patient. In fact, the need for an exhaustive study of the stones increases as the relationships between the type of stone and the etiological factors that predispose to this disease become evident. The enumeration (qualitative or quantitative) of the major components that make up the kidney stone (calcium oxalate monohydrate, calcium oxalate dihydrate, uric acid, calcium phosphates, cystine), which is obtained by the most commonly used analytical method, infrared spectroscopy (IR), is no longer enough to guide the urologist on the etiology of the disease. Only a detailed structural analysis and macro and micro components can provide key information on the etiology of the stone, and therefore, on the possible causes that have led to its formation. This study should conclude with a report that is provided to the Urologist. Obtaining this report involves a detailed study, sample by sample, which involves the systematic handling of stereoscopic microscopy, IR spectroscopy and scanning electron microscopy (SEM) with energy dispersive X-raymicroanalysis (EDAX).
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Affiliation(s)
- Félix Grases
- Laboratorio de Investigación en Litiasis Renal. Instituto Universitario de Investigación en Ciencias de la Salud (IUNICSIDISBA). Universidad de las Islas Baleares. Palma de Mallorca. España
| | - Antonia Costa-Bauza
- Laboratorio de Investigación en Litiasis Renal. Instituto Universitario de Investigación en Ciencias de la Salud (IUNICSIDISBA). Universidad de las Islas Baleares. Palma de Mallorca. España
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Vieira MS, Francisco PDC, Hallal ALLC, Penido MGMG, Bresolin NL. Association between dietary pattern and metabolic disorders in children and adolescents with urolithiasis. J Pediatr (Rio J) 2020; 96:333-340. [PMID: 30731051 PMCID: PMC9432078 DOI: 10.1016/j.jped.2018.11.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 10/17/2018] [Accepted: 11/19/2018] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE To describe the dietary patterns and occurrence of metabolic disorders in children and adolescents with urolithiasis treatment at a referral hospital in southern Brazil in order to learn the features of urolithiasis in this population to better develop preventive actions. METHODS Descriptive study conducted between 2016 and 2017 in a tertiary care referral hospital. Fourty patients aged 2-19 years old with urolithiasis proven by imaging were included. Clinical and dietary data were obtained through interviews and medical records. For statistical analyses, the chi-squared test was performed. RESULTS 40 individuals were analyzed. Mean age at diagnosis was 7.2±4 years. 25% were overweight or obese. 95% had metabolic disorders, hypocitraturia being the predominant type. Protein intake was adequate in all participants and carbohydrate intake, in 70% of them; 37.5% had lipid intake above recommended and 65% had low fiber intake. The mean daily sodium intake was 2.64g (±1.74), with 55% of participants ingesting more than the recommended amount. A total of 52.5% had low potassium intake, with a mean of 4.79g/day (±2.49). Calcium intake was adequate in 27.5%. No significant differences were identified in relation to mean daily consumption among participants with or without the various metabolic disorders. CONCLUSION Pediatric urolithiasis is often accompanied by metabolic disorders; therefore, metabolic evaluation should be part of the diagnostic process and subsequent analysis of these patients' dietary patterns, helping to optimize treatment and prevent recurrences and complications.
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Affiliation(s)
- Mariana S Vieira
- Universidade Federal de Santa Catarina (UFSC), Centro de Ciências da Saúde, Departamento de Pediatria, Florianópolis, SC, Brazil
| | - Priscila de C Francisco
- Universidade Federal de Santa Catarina (UFSC), Centro de Ciências da Saúde, Departamento de Pediatria, Florianópolis, SC, Brazil; Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil
| | - Ana Luiza L C Hallal
- Universidade de São Paulo (USP), São Paulo, SP, Brazil; Universidade Federal de Santa Catarina (UFSC), Centro de Ciências da Saúde, Departamento de Saúde Pública, Florianópolis, SC, Brazil
| | - Maria Goretti M G Penido
- University of Missouri, School of Medicine, The Childrens Mercy Hospitals and Clinics, Bone and Mineral Disorders Clinic and Research Laboratory, Section of Pediatric Nephrology, Kansas, United States; Santa Casa de Belo Horizonte, Serviço de Nefrologia, Unidade de Nefrologia Pediátrica, Belo Horizonte, MG, Brazil; Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Departamento de Pediatria, Belo Horizonte, MG, Brazil
| | - Nilzete L Bresolin
- Universidade Federal de Santa Catarina (UFSC), Centro de Ciências da Saúde, Departamento de Pediatria, Florianópolis, SC, Brazil; Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil; Hospital Infantil Joana de Gusmão, Unidades de Nefrologia Pediátrica e de Terapia Intensiva, Florianópolis, SC, Brazil Received 31 August 2018; accepted 31 October 2018.
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Abstract
INTRODUCTION AND OBJECTIVES Percutaneous nephrolithotomy (PCNL) is a standard, safe, and efficient method for large-volume renal calculi for all age groups. Nephrostomy tube constitutes an invaluable part of the nephrolithotomy operation. However, the nephrostomy tube has been recently replaced with ureteral catheter or double J-stent thanks to advances in urotechnology and operation equipment. The aim of the current article was to evaluate the safety and reliability of tubeless percutaneous nephrolithotomy in the geriatric population. METHODS Between January 2009 and September 2013, a total of 52 patients aged 65 years or elder with renal calculi bigger than 2cm underwent PCNL operation. The first group of 25 patients (48%) with a mean age of 70.0 years (std:±3,8) underwent tubeless PCNL whereas the second group consisting of 27 (52%) patients with a mean age of 71.3 years (std: ±4,0) underwent standard PCNL. The patients were randomly compared retrospectively in terms of burden of calculus, analgesic requirement, creatinine value, renal parenchymal thickness, Body-mass index (BMI), clavien score, length of hospitalization, and being calculus-free. RESULTS The groups were found to be similar in age, BMI, and gender (P>.05). Burden of calculus, duration of operation, and rate of narcotic analgesic use were found to be statistically significantly higher in the group of Standard PCNL group than in the Tubeless PCNL group (P<.05). Length of hospital stay was 1.7 days in the group of tubeless PCNL and 2.6 days in the standard PCNL group (P<.05). No significant difference was found between the groups in terms of fall in hemoglobin, creatinine, values of parenchymal thickness, and clavien score, preoperative blood transfusion, previous SWL, location of calculi, number of access, and rate of success (P>.05). Burden of calculus was 900 mm2 (304-4232) in the standard PCNL group and 600mm(2) (220-2660) in the tubeless PCNL group with the difference being statistically significant (P=.014). Overall success was achieved in 96.0 and 96.3% of tubeless PCNL and standard PCNL patients after one session of PCNL, respectively. CONCLUSIONS Tubeless percutaneous nephrolithotomy was found to be as safe and effective as standard PCNL in the geriatric population. It is recommended especially in this group of patients because of its advantages such as shorter length of hospitalization, less analgesic requirement, and earlier mobilization.
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Affiliation(s)
- H Ozturk
- Department of Urology, School of Medicine, Sifa University, Izmir, Turquía.
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