The impact of stenting prior to oral chemolysis of upper urinary tract uric acid stones.

Details

Serval ID
serval:BIB_9CB5BA7F3459
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
The impact of stenting prior to oral chemolysis of upper urinary tract uric acid stones.
Journal
International urology and nephrology
Author(s)
Tsaturyan A., Bosshard P., Bokova E., Bonny O., Stritt K., Roth B.
ISSN
1573-2584 (Electronic)
ISSN-L
0301-1623
Publication state
Published
Issued date
01/2022
Peer-reviewed
Oui
Volume
54
Number
1
Pages
37-45
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
To evaluate the impact of ureteral stenting on the success rate of oral chemolysis in the management of suspected uric acid upper urinary tract (UUT) stones.
Retrospective matched-pair analysis of 172 patients treated with oral chemolysis from 01/2010 to 12/2019. Patients with low density (upon non-contrast enhanced computer tomography [NCCT]), radiolucent (on plain radiography) urinary stones, a low urine pH (< 6) and/or history of uric acid urolithiasis were included. Potassium citrate and/or sodium bicarbonate were used for alkalization (target urine pH: 6.5-7.2). Patient 1:1 matching was performed for the presence of indwelling ureteral stent, stone diameter, stone density, and stone localization. Stone-free status was evaluated after 12 weeks using NCCT. Multivariable logistic regression analysis was used to assess factors affecting the outcome.
Mean patient age was 61 years (73% males). Mean stone size was 12 mm. Overall success rates after 12-weeks of chemolysis for stones at any localization in the UUT and ureteral stones were 60.5 and 77.3%, respectively. Smaller stone size (OR = 0.94; CI 0.888-0.992; p = 0.026) and lower pre-treatment urine pH (OR = 0.131; CI 0.023-0.737; p = 0.021) significantly increased the success of oral chemolysis. Ureteral stenting did not have any impact on the efficacy of oral chemolysis.
Oral chemolysis is an effective treatment modality for patients with UUT stones suspected of uric acid content irrespective of ureteral stenting. Smaller stone diameter and lower urine pH at diagnosis increase its efficacy.
Keywords
Administration, Oral, Aged, Combined Modality Therapy, Female, Humans, Kidney Calculi/drug therapy, Kidney Calculi/surgery, Male, Middle Aged, Potassium Citrate/administration & dosage, Retrospective Studies, Sodium Bicarbonate/administration & dosage, Stents, Treatment Outcome, Ureteral Calculi/drug therapy, Ureteral Calculi/surgery, Double J stent, Oral chemolysis, Ureteral stenting, Uric acid stone, Urine alkalization, Urolithiasis
Pubmed
Web of science
Create date
03/12/2021 9:36
Last modification date
10/08/2022 5:38
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