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• W2168444316 abstract "No AccessJournal of UrologyClinical Urology: Original Article1 Jan 1996Long-Term Incidence and Risks for Recurrent Stones Following Contemporary Management of Upper Tract Calculi in Patients with a Urinary Diversion Todd D. Cohen, Stevan B. Streem, and Gary Lammert Todd D. CohenTodd D. Cohen More articles by this author , Stevan B. StreemStevan B. Streem More articles by this author , and Gary LammertGary Lammert More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)66540-6AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The long-term rate of stone recurrence following contemporary minimally invasive management of calculi was determined in patients with urinary diversion and to identify specific risk factors for these recurrences. Materials and Methods: We followed for a minimum of 12 months 25 patients (29 renal units) with upper tract calculi associated with urinary diversion, and treated with extracorporeal shock wave lithotripsy and/or percutaneous nephrostolithotomy. The risk of recurrent stones at 5 years was determined by a Kaplan-Meier estimate, while potential risk factors for recurrence were analyzed using a log-rank comparison. Results: Stones recurred in 8 patients (32 percent) 18 to 61 months (mean 27.0) after treatment. The risk of new stone formation after 5 years was estimated to be 63.3 percent and was significantly greater in patients with recurrent bacteriuria after treatment. Neither stone history, type of procedure used, stone composition nor radiographic status of completion of treatment significantly influenced this risk. Conclusions: Contemporary management of upper tract calculi in patients with a urinary diversion is associated with a high recurrence rate, especially among those with recurrent bacteriuria, regardless of whether the patient is initially rendered stone-free. Continued close surveillance and antibiotic prophylaxis seem to be essential in this high risk patient population. References 1 : The pathogenesis of urinary tract calculi occurring after ileal conduit diversion: I. Clinical study. II. Conduit study. III. Prevention. J. Urol.1973; 109: 204. Link, Google Scholar 2 : Colonic urinary diversion: 10 years of experience. J. Urol.1975; 113: 302. Link, Google Scholar 3 : Effect of urinary intestinal diversion on urinary risk factors for urolithiasis. J. Urol.1995; 153: 37. Link, Google Scholar 4 : The fate of residual fragments after extracorporeal shock wave lithotripsy monotherapy of infection stones. J. Urol.1991; 145: 6. Link, Google Scholar 5 : Can extracorporeal shock wave lithotripsy eradicate persistent urinary infection associated with infected stones?. J. Urol.1988; 140: 257. Link, Google Scholar 6 : Long-term incidence and risk factors for recurrent stones following percutaneous nephrostolithotomy or percutaneous nephrostolithotomy/extracorporeal shock wave lithotripsy for infection related calculi. J. Urol.1995; 153: 584. Link, Google Scholar 7 : Selective minimally invasive management of calculi in patients with urinary diversions. J. Urol.1994; 152: 1091. Link, Google Scholar 8 : Management of upper tract calculi in patients with tubularized urinary diversions. J. Urol.1991; 145: 266. Link, Google Scholar 9 : Recurrent urolithiasis following anatrophic nephrolithotomy. J. Urol.1981; 125: 471. Link, Google Scholar 10 : Bacteriuria following extracorporeal shock wave lithotripsy of infection stones. J. Urol.1988; 140: 254. Link, Google Scholar Department of Urology, Cleveland Clinic Foundation, Cleveland, Ohio.© 1996 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byAssimos D (2018) Re: Characterization of Urolithiasis in Patients following Lower Urinary Tract Reconstruction with Intestinal SegmentsJournal of Urology, VOL. 198, NO. 3, (479-479), Online publication date: 1-Sep-2017.Singla N, Montie J, Lee C, Wolf J and Faerber G (2018) Experience with 45 Consecutive Patients with Neobladders Undergoing Retrograde Ureteroscopy for Upper Tract AbnormalitiesUrology Practice, VOL. 2, NO. 5, (244-249), Online publication date: 1-Sep-2015.Blair B, Huang G, Arnold D, Li R, Schlaifer A, Anderson K, Engebretsen S, Wallner C, Olgin G and Baldwin D (2018) Reduced Fluoroscopy Protocol for Percutaneous Nephrostolithotomy: Feasibility, Outcomes and Effects on Fluoroscopy TimeJournal of Urology, VOL. 190, NO. 6, (2112-2116), Online publication date: 1-Dec-2013.GILBERT S and HENSLE T (2018) METABOLIC CONSEQUENCES AND LONG-TERM COMPLICATIONS OF ENTEROCYSTOPLASTY IN CHILDREN: A REVIEWJournal of Urology, VOL. 173, NO. 4, (1080-1086), Online publication date: 1-Apr-2005. Volume 155Issue 1January 1996Page: 62-65 Advertisement Copyright & Permissions© 1996 by American Urological Association, Inc.MetricsAuthor Information Todd D. Cohen More articles by this author Stevan B. Streem More articles by this author Gary Lammert More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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