The change in upper tract urolithiasis composition, surgical treatments and outcomes of para and quadriplegic patients over time

Marisa M. Clifton, Matthew T. Gettman, David E. Patterson, Laureano Rangel, Amy Krambeck

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Stone disease in patients with spinal cord injury is a source of morbidity and mortality. Previous studies have indicated a decrease in infection-based urolithiasis in recent decades. We aimed to identify changes in stone composition and surgical outcomes in patients with para and quadriplegia over time. A retrospective review of para and quadriplegic patients from 1986 to 2011 who underwent surgical intervention for urolithiasis was performed, identifying 95 patients. The Mantel–Haenszel Chi square test was used to compare change in stone composition over time. The mean patient age was 44.0 years (range 18–88) and treatment included percutaneous nephrolithotomy (PCNL) 40 (42.1 %), ureteroscopy 28 (29.5 %), shock wave lithotripsy (SWL) 26 (27.4 %), and nephrectomy 1 (1 %). Overall stone-free status was found in 47.4 % with 19.0 % requiring a repeat procedure. The median hospital stay for patients undergoing SWL was 2.5 days, ureteroscopy 5 days, and PCNL 6 days. Infection-based stone composition was identified in 23 patients (36.5 %). We evaluated the linear change in percent of each stone component over time and identified increasing components of calcium oxalate dihydrate (p = 0.002) and calcium carbonate (p = 0.009). However, over a period of 25 years, the incidence of infection-based stone did not change (p = 0.57). Para and quadriplegic patients with urolithiasis can be difficult to treat surgically with prolonged hospitalizations, low stone-free status, and often require additional procedures. Despite improvements in antibiotic agents and management of neurogenic bladders, infection-based calculi continue to be a significant source of morbidity to this patient population.

Original languageEnglish (US)
Pages (from-to)415-419
Number of pages5
JournalUrolithiasis
Volume42
Issue number5
DOIs
StatePublished - 2014
Externally publishedYes

Fingerprint

Urolithiasis
Ureteroscopy
Percutaneous Nephrostomy
Lithotripsy
Infection
Morbidity
Neurogenic Urinary Bladder
Calcium Oxalate
Quadriplegia
Calcium Carbonate
Calculi
Chi-Square Distribution
Nephrectomy
Spinal Cord Injuries
Length of Stay
Hospitalization
Anti-Bacterial Agents
Mortality
Incidence

Keywords

  • Kidney calculi
  • Paraplegia
  • Quadriplegia
  • Urolithiasis

ASJC Scopus subject areas

  • Urology
  • Medicine(all)

Cite this

The change in upper tract urolithiasis composition, surgical treatments and outcomes of para and quadriplegic patients over time. / Clifton, Marisa M.; Gettman, Matthew T.; Patterson, David E.; Rangel, Laureano; Krambeck, Amy.

In: Urolithiasis, Vol. 42, No. 5, 2014, p. 415-419.

Research output: Contribution to journalArticle

Clifton, Marisa M. ; Gettman, Matthew T. ; Patterson, David E. ; Rangel, Laureano ; Krambeck, Amy. / The change in upper tract urolithiasis composition, surgical treatments and outcomes of para and quadriplegic patients over time. In: Urolithiasis. 2014 ; Vol. 42, No. 5. pp. 415-419.
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