1275: Outcomes of Percutaneous Renal Surgery Stratified According to Body Mass Index and Kidney Stone Size

Immediate removal of staghorn kidney stones is important to prevent life-threatening complications. With the advancement of endoscopic technology, retrograde intrarenal surgery (RIRS) is now an alternate treatment to the standard percutaneous nephrolithotomy (PCNL) for stones removal. However, when used to treat large stones (>3cm), RIRS can cause the formation steinstrasse (SS). Here, we present the case of a 68-year-old man with multiple stones in the collecting system of the right kidney after initial treatment with RIRS. After two years of multiple interventions, the SS was completely removed. To prevent this complication in patients, a detailed assessment of the stone (size, location) and renal anatomy should be completed before RIRS is performed.

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The Association of Increasing Body Mass Index and Kidney Stone Disease

The Journal of Urology ◽

10.1016/j.juro.2009.09.085 ◽

2010 ◽

Vol 183 (2) ◽

pp. 571-575 ◽

Cited By ~ 75

Author(s):

Michelle J. Semins ◽

Andrew D. Shore ◽

Martin A. Makary ◽

Thomas Magnuson ◽

Roger Johns ◽

...

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Kidney Stone ◽

Stone Disease ◽

Kidney Stone Disease

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The factors that affecting shockwave lithotripsy treatment outcome of kidney stones

10.22541/au.162465128.81321037/v1 ◽

2021 ◽

Author(s):

MEHMET VEHBİ KAYRA ◽

Mehmet Resit GOREN ◽

Cevahir Ozer ◽

Ferhat Kilinc

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Kidney Stones ◽

Treatment Success ◽

Laboratory Data ◽

Stone Analysis ◽

Stone Size ◽

Tissue Density ◽

Stone Burden ◽

Stone Density

Bacground: We aimed to analyze combination of the schockwave lithotripy (SWL) success predictors. Methods: In this retrospective study, the outcomes of the patients with kidney stones treated with SWL were analyzed. Adult patients (≥18 years) with complete records with non-contrast computed tomography (NCCT), stone analysis, laboratory data were involved in the study. Patients who were with urinary system anomalies, who were receiving alpha-blocker and/or calcium channel blockers and whom with impaired kidney function were excluded. The effect of stone density, skin-to-stone distance (SSD), perirenal tissue density (PTD), subcutaneous tissue density (STD), stone size, stone burden, stone localization, infundibulopelvic angle (IA), as well as body mass index (BMI) and stone analysis results on the success of the treatment was evaluated. Results: SSD, PTD, STD, stone localization, IA, as well as body-mass index, did not have any association with SWL success. Stone size and stone burden had a significant association with treatment success (p = 0.0001), and the cut-off values determined for stone size and stone burden were 12.95 mm (p = 0.0006) and 121.38 mm2 (p = 0.004) respectively. Stone density also had a significant association with treatment success (p = 0.0001), and the cut-off value determined for stone density was 739 HU (Hounsfield Unit) (p = 0.001). Treatment success was significantly lower in cystine and calcium oxalate monohydrate stones compared to other stone types (p = 0.019). Conclusion: Significant markers that determine SWL effectiveness are stone size, stone burden, stone density and, besides, stone type.

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Benefits of Laparoscopic Renal Surgery Are More Pronounced in Patients with a High Body Mass Index

European Urology ◽

10.1016/s0302-2838(03)00092-7 ◽

2003 ◽

Vol 43 (5) ◽

pp. 522-527 ◽

Cited By ~ 35

Author(s):

H.C. Klingler ◽

M. Remzi ◽

G. Janetschek ◽

M. Marberger

Keyword(s):

Body Mass Index ◽

Body Mass ◽

High Body Mass Index ◽

Renal Surgery ◽

High Body

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Case Report: An occurrence of steinstrasse in retrograde intra renal surgery for a large staghorn kidney stone – difficulty managing surgical outcomes

F1000Research ◽

10.12688/f1000research.22448.1 ◽

2020 ◽

Vol 9 ◽

pp. 184

Author(s):

Ponco Birowo ◽

Nur Rasyid ◽

Widi Atmoko ◽

Bobby Sutojo

Keyword(s):

Case Report ◽

Surgical Outcomes ◽

Kidney Stone ◽

Renal Surgery ◽

Retrograde Intrarenal Surgery ◽

Stone Size ◽

Life Threatening ◽

Detailed Assessment ◽

Staghorn Stone ◽

Staghorn Stones

Immediate removal of staghorn stones is compulsory to prevent life-threatening complications. The advancement of endoscopic technology makes retrograde intrarenal surgery (RIRS) a favorable treatment to remove large stones over the standard percutaneous nephrolithotomy (PCNL). Without careful considerations, it can cause the formation of steinstrasse. Here, we present the case of a 68-year-old man with multiple stones along his right urogenital duct after being treated with RIRS to remove a staghorn stone. After 2 years of multiple interventions, the steinstrasse was completely removed. To prevent this complication, detailed assessment of the stone (size, location) and renal anatomy should be performed prior to the procedure.

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Re: the Association of Increasing Body Mass Index and Kidney Stone Disease

The Journal of Urology ◽

10.1016/j.juro.2010.12.055 ◽

2011 ◽

Vol 185 (5) ◽

pp. 1984-1985

Author(s):

Jiang Jun Yi ◽

Li Jin Yi ◽

Gao Zhi Xiang ◽

Wang Wu Qing ◽

Liu Ji Yong ◽

...

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Kidney Stone ◽

Stone Disease ◽

Kidney Stone Disease

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BODY MASS INDEX RELATIONS WITH THE DIFFICULTIES AND COMPLICATIONS OF PERCUTANEOUS NEPHROLITHOTOMY

Indonesian Journal of Urology ◽

10.32421/juri.v23i2.255 ◽

2016 ◽

Vol 23 (2) ◽

Author(s):

Fauriski Febrian Prapiska ◽

Sunaryo Hardjowijoto ◽

Doddy M Soebadi ◽

Tarmono Djojodimedjo

Keyword(s):

Body Mass ◽

Percutaneous Nephrolithotomy ◽

Kidney Stone ◽

Open Surgery ◽

Stone Size ◽

Stone Free Rate ◽

Patients With Diabetes ◽

Grade Ii ◽

The Right ◽

Free Rate

Objective: To identified outcomes and complications of percutaneous nephrolithotomy (PCNL) in patients of various body mass indices (BMI) to determine the safety of this procedure in patients with elevated BMI.Material & methods: The analytic observational prospective study of patients who underwent PCNL between February to July 2015 in the operating room Soetomo General Hospital Surabaya. Specifically, BMI, stone-free rates, difficulties duringsurgery, complications, and Clavien score were assessed. We evaluate the independent contribution of BMI as a predictor of outcomes. Results: There were 35 selected patients with kidney stone and planned to PCNL, 20 patients were included and 15 patients were excluded from this study. The patients consisted of 10 men (50%) and 10 women (50%). Mean age was 47.55 years (range 33-75). There were 4 patients with diabetes (20%), and 10 patients with hypertension (50%). Mean stone size was 23.30 mm. Stone location was 11 patients (55%) in the right kidney, and 9 patients (45%) in the left. There were 12 patients (60%) with a single stone, and 8 patients (40%) with multiple stones. BMI values were distributed as follows,underweight 1 patient (5%), normoweight 7 patients (35%), overweight 6 patients (30%), obesity 6 patients (30%). Mean skin to stone distance (SSD) was 87.56 mm. Stone free rate was 55%, and difficulties during surgery only seen in 1 patient (5%) bleeding profusely and open surgery was performed. Clavien score in these patients were grade I in 11 patients (55%), grade II in 7 patients (35%), and grade IIIB in 2 patients (10%). The BMI had no significant effect with Intra operative and postoperative difficulties (0.390. p <0.05. CI 95%). However the lower stone free rate had significant effect (0.040. p <0.05. CI 95%).Conclusion: BMI had no significant effect with Intraoperative and postoperative difficulties in PCNL.However, the lower stone-free rate risk associated with elevated BMI was significant.

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