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Ureteroscopy : A population based study of clinical complications and possible risk factors for stone surgery

Wagenius, Magnus LU ; Rydberg, Mattias ; Popiolek, Marcin ; Forsvall, Andreas LU ; Stranne, Johan and Linder, Adam LU (2019) In Central European Journal of Urology 72(3). p.285-295
Abstract

Introduction The aim of this study was to describe the complications of ureteroscopy (URS) and to investigate whether performing URS outside normal working hours leads to increased risk for clinically significant complications. Material and methods A cohort of 486 consecutive patients treated with URS, with a total of 567 sessions between 2009 and 2015 at Helsingborg/Ängelholm Hospital, Sweden, was analyzed. Outcome was complications within 14 days after URS treatment. Results We found no increased risk of complications related to URS performed outside normal working hours. Stone-free rate (SFR) in the distal third of the ureter was 95.2% (315/331), in the middle ureter 92.8% (90/97), in the proximal ureter 84.0% (63/75) and 69.0%... (More)

Introduction The aim of this study was to describe the complications of ureteroscopy (URS) and to investigate whether performing URS outside normal working hours leads to increased risk for clinically significant complications. Material and methods A cohort of 486 consecutive patients treated with URS, with a total of 567 sessions between 2009 and 2015 at Helsingborg/Ängelholm Hospital, Sweden, was analyzed. Outcome was complications within 14 days after URS treatment. Results We found no increased risk of complications related to URS performed outside normal working hours. Stone-free rate (SFR) in the distal third of the ureter was 95.2% (315/331), in the middle ureter 92.8% (90/97), in the proximal ureter 84.0% (63/75) and 69.0% (40/58) in renal pelvis. The overall complication rate was 10.6% (n = 60). None of the potential risk factors for complications showed any significance when adjusted for age and gender. We found an inverse relationship between stenting and SFR (p = 0.002). The most common preoperatively cultured bacteria was Escherichia coli. With adequate antibiotics, there was no increased risk of complications. There was an increased risk of complications after URS related to age, but not with gender. Conclusions URS in modern setting provides excellent results with adequate SFR and low morbidity. Time of day, the presence of urological specialized operating nurses did not affect the risk of complications and we found no other significant risk factors for complications. Escherichia coli was the most commonly found bacteria in preoperative cultures. The risk of complications increases with age. For patients >65 years old, this should be considered in preoperative counseling.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Complications, Infection, Monotherapy, Stone, Ureteric stone, Ureteroscopy
in
Central European Journal of Urology
volume
72
issue
3
pages
11 pages
publisher
Panstwowy Zaklad Wydawnictw Lekarskich
external identifiers
  • pmid:31720032
  • scopus:85073471689
ISSN
2080-4806
DOI
10.5173/ceju.2019.1951
language
English
LU publication?
yes
id
dc62b98f-3c01-4beb-b33b-7d1b9d21c639
date added to LUP
2019-10-29 13:43:38
date last changed
2020-08-13 02:32:12
@article{dc62b98f-3c01-4beb-b33b-7d1b9d21c639,
  abstract     = {<p>Introduction The aim of this study was to describe the complications of ureteroscopy (URS) and to investigate whether performing URS outside normal working hours leads to increased risk for clinically significant complications. Material and methods A cohort of 486 consecutive patients treated with URS, with a total of 567 sessions between 2009 and 2015 at Helsingborg/Ängelholm Hospital, Sweden, was analyzed. Outcome was complications within 14 days after URS treatment. Results We found no increased risk of complications related to URS performed outside normal working hours. Stone-free rate (SFR) in the distal third of the ureter was 95.2% (315/331), in the middle ureter 92.8% (90/97), in the proximal ureter 84.0% (63/75) and 69.0% (40/58) in renal pelvis. The overall complication rate was 10.6% (n = 60). None of the potential risk factors for complications showed any significance when adjusted for age and gender. We found an inverse relationship between stenting and SFR (p = 0.002). The most common preoperatively cultured bacteria was Escherichia coli. With adequate antibiotics, there was no increased risk of complications. There was an increased risk of complications after URS related to age, but not with gender. Conclusions URS in modern setting provides excellent results with adequate SFR and low morbidity. Time of day, the presence of urological specialized operating nurses did not affect the risk of complications and we found no other significant risk factors for complications. Escherichia coli was the most commonly found bacteria in preoperative cultures. The risk of complications increases with age. For patients &gt;65 years old, this should be considered in preoperative counseling.</p>},
  author       = {Wagenius, Magnus and Rydberg, Mattias and Popiolek, Marcin and Forsvall, Andreas and Stranne, Johan and Linder, Adam},
  issn         = {2080-4806},
  language     = {eng},
  number       = {3},
  pages        = {285--295},
  publisher    = {Panstwowy Zaklad Wydawnictw Lekarskich},
  series       = {Central European Journal of Urology},
  title        = {Ureteroscopy : A population based study of clinical complications and possible risk factors for stone surgery},
  url          = {http://dx.doi.org/10.5173/ceju.2019.1951},
  doi          = {10.5173/ceju.2019.1951},
  volume       = {72},
  year         = {2019},
}