UP-85 Characterizing patients with multiple same-sided ureteric stones
Thursday June 27, 2019 from
TBD
Presenter

Matthew A Mancuso, Canada

Medical Student

Faculty of Medicine and Dentistry

University of Alberta

Abstract

Characterizing patients with multiple same-sided ureteric stones

Matthew Mancuso1, Mark Assmus1, Callum Lavoie1, Shubhadip (Shubha) K. De1.

1Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada

Introduction: Currently, there is no information on how to counsel patients who present with multiple same sided ureteric stones (MUS). Therefore, the objective of this study is to understand the differences in outcomes of patients with MUS vs those with single ureteric stones (SUS).

Methods: A prospectively collected cohort of patients with MUS was created. Inclusion criteria consisted of: 2 ipsilateral ureteral stones on imaging, age >18, no prior treatment for current stone burden. A comparison cohort was then used from our Acute Stone Clinic (inclusion: 1 ureteral stone, >18, no prior treatment for current stone). Univariate logistic regression analyses and descriptive statistics were performed with SPSS® 20.0 (significance p <0.05).

Results: 79 MUS patients were compared to 101 SUS patients. MUS patients had 2.21∓0.66 ureteric stones, were 57∓13y, 71% male (vs. 49∓15y, 65% male SUS). There was a difference in stone size (MUS 6.4mm vs SUS 7.2mm; p=.03), and MUS patients were more likely to have had prior stones (66% vs 42%; p=.001) being 5.9 times more likely to have had a prior stone procedure. MUS were exposed to more imaging studies at presentation (OR=5.4; 95% CI=2.8-10) and follow up (OR=3.2; 95% CI=1.7-6; p=.000) and were more likely to spontaneously pass a stone prior to planned intervention (OR=41; 95% CI=12-141; p=.0001). Conservative management was successful in 33% MUS vs 34% SUS (p=.932), and there were no differences in resolution time (p=0.4). Ureteroscopy (URS) was performed on 58% MUS vs 51% SUS patients (p=.30), and shock wave lithotripsy in 10% MUS vs 26% SUS (p=.01).

Conclusion: This retrospective study has identified MUS patients as more likely to be recurrent stone formers who have undergone previous stone interventions. Conservative management appears to be as successful as those with SUS, with no differences in time to resolution of their stone events. Though SWL is used less frequently, there were no differences in the use of URS between populations.


Lectures by Matthew A Mancuso


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