SWL literature
SWL Literature

Iremashvili V. et al., 2021: Gender-related differences in the risk factors for repeat stone surgery

Iremashvili V, Li S, Dresner SL, Best SL, Hedican SP, Nakada SY.
Department of Urology, University of Wisconsin School of Medicine and Public Health, University of Wisconsin Medical Foundation Centennial Building, 1685 Highland Avenue, Madison, WI, 53705, USA.
Department of Urology, University of Wisconsin School of Medicine and Public Health, University of Wisconsin Medical Foundation Centennial Building, 1685 Highland Avenue, Madison, WI, 53705, USA.

Abstract

Our objective was to analyze and compare the associations between potential risk factors for nephrolithiasis and repeat stone surgery in male and female patients. We retrospectively analyzed 1970 patients who had stone surgery at our institution in the period from January 2009 to May 2017, were older than 18 years and had at least 12 months of postoperative follow-up. Our definition of surgical recurrence included repeat surgery on the same renal unit or on the opposite renal unit if the original imaging did not demonstrate significant stones on that side. Uni- and multivariate Cox regression models were built for each gender. We also explored the interactions between gender and other patient's characteristics in their effect on the risk of recurrence. Ureteroscopy was the most common treatment modality for both first (83%) and repeat (87%) procedures. Over a mean follow-up of 4.3 years (median 3.8, interquartile range 2.2-6.0), 413 (21.0%) patients had a surgical recurrence. In multivariate analyses, hypertension, diabetes, Caucasian race and younger age (less than 60 years) were significantly associated with the risk of surgical recurrence only in females. Interaction between these characteristics and gender was significant indicating a larger effect on the risk of surgical recurrence in females compared to males. Our study demonstrated a number of differences in the predictors of repeat surgery for nephrolithiasis between males and females. If confirmed by future studies these differences may be helpful for optimizing nephrolithiasis prevention efforts.
Urolithiasis. 2021 Feb 11. doi: 10.1007/s00240-021-01255-5. Online ahead of print. PMID: 33575928. 

0
 

Commentaires 1

Hans-Göran Tiselius le vendredi 11 juin 2021 08:30

It is commonly accepted that patients should be given recurrence preventive treatment after active removal or passage of stone. This report provides some interesting data in this regard although SWL had been used in less than 5% of the cases. The definition of recurrence was need of repeated surgical procedures on the same or contralateral side.

Unfortunately, no information wis given on stone composition.

Clinical experience has clearly confirmed that not all patients can be or should be offered pharmacological preventive treatment. Therefore, it is of value that this report gives some clues to the selection of patients in need of powerful treatment.

It is most interesting to note that surgical recurrence was more common in women than in men.
Whereas UTI increased the recurrence risk in both men and women, young age (

It is commonly accepted that patients should be given recurrence preventive treatment after active removal or passage of stone. This report provides some interesting data in this regard although SWL had been used in less than 5% of the cases. The definition of recurrence was need of repeated surgical procedures on the same or contralateral side. Unfortunately, no information wis given on stone composition. Clinical experience has clearly confirmed that not all patients can be or should be offered pharmacological preventive treatment. Therefore, it is of value that this report gives some clues to the selection of patients in need of powerful treatment. It is most interesting to note that surgical recurrence was more common in women than in men. Whereas UTI increased the recurrence risk in both men and women, young age (
Invité
mardi 27 juillet 2021

By accepting you will be accessing a service provided by a third-party external to https://storzmedical.com/

Linkedin Channel Facebook Channel Instagram Channel Twitter Youtube Channel