Amy Krambeck1, Nienke Wijnstok2, Peter Olbert3, George Mitroi4, Simon Bariol5, Hemendra N Shah6, Ahmed S El-Abd7, Bulent Onal8, Jean de la Rosette2. 1. 1 Department of Urology, IU Health , Indianapolis, Indiana. 2. 2 Department of Urology, AMC University Hospital , Amsterdam, The Netherlands . 3. 3 Department of Urology, University Medical Center , Marburg, Germany . 4. 4 Department of Urology, SCJU Craiova , Craiova, Romania . 5. 5 Department of Urology, Westmead Hospital and University of Sydney , Sydney, Australia . 6. 6 Department of Urology, S. L. Raheja (Fortis associate) Hospital , Mumbai, India . 7. 7 Department of Urology, Tanta University , Tanta, Egypt . 8. 8 Department of Urology, Istanbul University , Cerrahpasa School of Medicine, Istanbul, Turkey .
Abstract
INTRODUCTION: Although ureteroscopy (URS) has been established as a viable treatment for stones in obese patients, its safety and success has not been fully elucidated. The current study describes the worldwide prevalence of obesity in patients with urolithiasis and examines trends in URS outcomes, safety, and efficacy. METHODS: This study utilized the Clinical Research Office of the Endourological Society (CROES) URS Global Study, which was a prospective, multicenter study including 11,885 patients treated with URS for urinary stones at 1 of 114 urology departments across 32 countries. The relationship between body mass index (BMI), diabetes, and creatinine, with retreatment, stone-free rates, complications, and long hospital stay, was examined with a multivariate logistic regression analyses. RESULTS: Of the 10,099 URS patients with BMI data, 17.4% were obese and 2.2% were super obese. Overall, 86.7% patients were stone free and 16.8% required retreatment. Higher BMI was associated with lower stone-free rates, and any deviation from normal weight was associated with higher retreatment rates. In multivariate analysis controlling for several variables including stone size, the association between BMI and lower stone-free rates with higher retreatment rates persisted. Intraoperative complications occurred in 518 (5.1%) patients, and 343 (3.4%) experienced a postoperative complication. Postoperative complications were more frequent in the underweight and super obese subjects, and there was no relationship between BMI and intraoperative complications. DISCUSSION: Although URS for stone disease was found to be an overall safe procedure for obese and super obese patients, efficacy of the procedure may be lower compared with normal-weight subjects and higher retreatment rates may be necessary.
INTRODUCTION: Although ureteroscopy (URS) has been established as a viable treatment for stones in obesepatients, its safety and success has not been fully elucidated. The current study describes the worldwide prevalence of obesity in patients with urolithiasis and examines trends in URS outcomes, safety, and efficacy. METHODS: This study utilized the Clinical Research Office of the Endourological Society (CROES) URS Global Study, which was a prospective, multicenter study including 11,885 patients treated with URS for urinary stones at 1 of 114 urology departments across 32 countries. The relationship between body mass index (BMI), diabetes, and creatinine, with retreatment, stone-free rates, complications, and long hospital stay, was examined with a multivariate logistic regression analyses. RESULTS: Of the 10,099 URS patients with BMI data, 17.4% were obese and 2.2% were super obese. Overall, 86.7% patients were stone free and 16.8% required retreatment. Higher BMI was associated with lower stone-free rates, and any deviation from normal weight was associated with higher retreatment rates. In multivariate analysis controlling for several variables including stone size, the association between BMI and lower stone-free rates with higher retreatment rates persisted. Intraoperative complications occurred in 518 (5.1%) patients, and 343 (3.4%) experienced a postoperative complication. Postoperative complications were more frequent in the underweight and super obese subjects, and there was no relationship between BMI and intraoperative complications. DISCUSSION: Although URS for stone disease was found to be an overall safe procedure for obese and super obesepatients, efficacy of the procedure may be lower compared with normal-weight subjects and higher retreatment rates may be necessary.
Authors: Jakub Marek Ratajczak; Taras Hladun; Bartosz Krenz; Krzysztof Bromber; Maciej Salagierski; Michał Marczak Journal: Int J Environ Res Public Health Date: 2022-01-20 Impact factor: 3.390