Sacha L Moore1, Paul Cook2, Vincent de Coninck3, Etienne Xavier Keller4, Olivier Traxer5, Laurian Dragos6, Iqbal S Shergill7, Bhaskar K Somani8. 1. North Wales Clinical Research Centre, Wrexham Maelor Hospital, Wrexham, Wales, UK. sacha.moore@wales.nhs.uk. 2. Department of Biochemical Pathology & Metabolic Medicine, University Hospital Southampton, Southampton, UK. 3. Department of Urology, AZ Klina, Brasschaat, Belgium. 4. Department of Urology, University Hospital Zurich, University of Zurich, Zurich, Switzerland. 5. Department of Urology, Sorbonne Université, GRC n°20 Lithiase renale, AP-HP, Hôpital Tenon, Paris, F-75020, France. 6. Department of Urology, University of Medicine and Pharmacy Victor Babeş Timişoara, Timişoara, Romania. 7. Department of Urology, Wrexham Maelor Hospital and Clinical Director, North Wales Clinical Research Centre, Wrexham, Wales, UK. 8. Department of Urology, University Hospital Southampton, Southampton, UK.
Abstract
PURPOSE OF REVIEW: Cystine stone patients can be difficult to manage with frequent recurrences. We performed a systematic review with a view to assessing interventions, compliance and their long-term outcomes. RECENT FINDINGS: Ten retrospective observational studies (253 patients) assessed the outcomes and long-term follow-up of cystine stone patients. The mean length of follow-up was 9.6 years (range 3.5-21.8 years). The overall mean number of surgical procedures/patient was 5.7 (range 2-9.8/patient) with the overall mean number of surgical procedures/patient/year at 0.59 (range 0.22-1.32/patient/year). While open surgery has decreased over the last decade and PCNL has been stable, there seems to be a rise of RIRS during this period. Patients with cystine stones need periodic interventions for stone recurrences despite medical management, with limited data showing the impact on renal function. While the management is individualised, wide variability exists with often poor and incomplete patient data.
PURPOSE OF REVIEW: Cystine stone patients can be difficult to manage with frequent recurrences. We performed a systematic review with a view to assessing interventions, compliance and their long-term outcomes. RECENT FINDINGS: Ten retrospective observational studies (253 patients) assessed the outcomes and long-term follow-up of cystine stone patients. The mean length of follow-up was 9.6 years (range 3.5-21.8 years). The overall mean number of surgical procedures/patient was 5.7 (range 2-9.8/patient) with the overall mean number of surgical procedures/patient/year at 0.59 (range 0.22-1.32/patient/year). While open surgery has decreased over the last decade and PCNL has been stable, there seems to be a rise of RIRS during this period. Patients with cystine stones need periodic interventions for stone recurrences despite medical management, with limited data showing the impact on renal function. While the management is individualised, wide variability exists with often poor and incomplete patient data.