Outcomes of ureteroscopy (URS) for kidney stone disease (KSD) in patients with spinal cord injury (SCI)
BAUS ePoster online library. Oliver R.
Jun 26, 2018; 211310
Ms. Rachel Oliver
Ms. Rachel Oliver
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Introduction: The management of KSD in SCI patients is complex. Minimal data is available regarding treatment outcomes in this cohort with URS. We present the largest UK series of URS in SCI patients.

Patients and Methods: A retrospective analysis was made of all SCI patients undergoing URS and laser lithotripsy between 2005-17 at our supra-regional spinal injuries unit.

Results: A total of 41 procedures were performed in 21 patients with a mean age of 49 years (range 17-69) and a male:female ratio of 6:1. Almost a quarter had undergone previous urinary tract reconstruction. Mean total stone length was 27mm (range 5-59mm) with the majority of stones in the kidney (97%). Eleven patients (27%) had a pre-operative stent and access was achieved in 98%. An access sheath was used in 26 cases (63%) and a post-operative stent was required in 11 (27%). Mean length of stay was 2 days (median 1; range 0-9). Complications occurred in 10 cases (24%), which were all Clavien-Dindo grade II. Residual fragments were noted in 16 cases (42%). Stone recurrence occurred in 16 cases (42%); 4 within 12 months (10.5%) and 12 after a year (31.6%). Further intervention within a year was required in 11 cases (27%) excluding 7 planned multi-stage procedures. The stone-free rate at 12 months was 47%.

Conclusion: SCI patients undergoing URS for KSD have lower stone-free rates than other reported series and a higher complication rate. Reasons for this include stone size and composition, altered physiology and previous urinary tract reconstruction.
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