Ureteroscopy with laser lithotripsy for urolithiasis in the spinal cord injury population

T. Wolfe, A. P. Klausner, L. L. Goetz, A. B. King, T. Hudson, David Gater

Research output: Contribution to journalReview article

11 Citations (Scopus)

Abstract

Study design: Retrospective study. Objectives: The purpose of this investigation was to review the outcomes and safety of retrograde ureteroscopic laser lithotripsy (URS) for the treatment of urolithiasis in the spinal cord injury (SCI) population. Setting: Virginia, USA. Methods: All patients with SCI who underwent URS with holmium: YAG laser lithotripsy for urolithiasis over a 15-year period were identified. Stone size, location and number at presentation were recorded. Information regarding patient characteristics, intra-operative complications, surgical efficacy, stone clearance, peri-operative complications, and follow-up stone events was collected and analyzed. Results: A total of 67 URS procedures were performed on 29 SCI patients during the study period with an average follow-up of 3.4 years. Patients had an average of 2.3 ipsilateral ureteroscopies. The majority (85.1%) used indwelling catheters for long-term bladder management, and complete stone clearance after the first procedure was 34.3%. Of the 44 cases with residual stones >4 mm, 20 (45.5%) were secondary to technical or procedural limitations. The intra-operative complication rate was comparable to non-SCI studies at 1.5%, but peri-operative complications were significantly higher at 29.9% with the majority due to urosepsis. Factors associated with peri-operative complications include chronic obstructive pulmonary disease, motor incomplete injuries and lack of a pre-operative ureteral stent. Conclusion: URS in the SCI population is an effective treatment for ureteral or renal stones but may be associated with greater risks and reduced efficacy.Sponsorship: None.

Original languageEnglish (US)
Pages (from-to)156-160
Number of pages5
JournalSpinal Cord
Volume51
Issue number2
DOIs
StatePublished - Feb 1 2013

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Laser Lithotripsy
Ureteroscopy
Urolithiasis
Spinal Cord Injuries
Population
Indwelling Catheters
Solid-State Lasers
Wounds and Injuries
Chronic Obstructive Pulmonary Disease
Stents
Urinary Bladder
Retrospective Studies
Kidney
Safety
Therapeutics

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

Cite this

Wolfe, T., Klausner, A. P., Goetz, L. L., King, A. B., Hudson, T., & Gater, D. (2013). Ureteroscopy with laser lithotripsy for urolithiasis in the spinal cord injury population. Spinal Cord, 51(2), 156-160. https://doi.org/10.1038/sc.2012.86
Wolfe, T. ; Klausner, A. P. ; Goetz, L. L. ; King, A. B. ; Hudson, T. ; Gater, David. / Ureteroscopy with laser lithotripsy for urolithiasis in the spinal cord injury population. In: Spinal Cord. 2013 ; Vol. 51, No. 2. pp. 156-160.
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abstract = "Study design: Retrospective study. Objectives: The purpose of this investigation was to review the outcomes and safety of retrograde ureteroscopic laser lithotripsy (URS) for the treatment of urolithiasis in the spinal cord injury (SCI) population. Setting: Virginia, USA. Methods: All patients with SCI who underwent URS with holmium: YAG laser lithotripsy for urolithiasis over a 15-year period were identified. Stone size, location and number at presentation were recorded. Information regarding patient characteristics, intra-operative complications, surgical efficacy, stone clearance, peri-operative complications, and follow-up stone events was collected and analyzed. Results: A total of 67 URS procedures were performed on 29 SCI patients during the study period with an average follow-up of 3.4 years. Patients had an average of 2.3 ipsilateral ureteroscopies. The majority (85.1{\%}) used indwelling catheters for long-term bladder management, and complete stone clearance after the first procedure was 34.3{\%}. Of the 44 cases with residual stones >4 mm, 20 (45.5{\%}) were secondary to technical or procedural limitations. The intra-operative complication rate was comparable to non-SCI studies at 1.5{\%}, but peri-operative complications were significantly higher at 29.9{\%} with the majority due to urosepsis. Factors associated with peri-operative complications include chronic obstructive pulmonary disease, motor incomplete injuries and lack of a pre-operative ureteral stent. Conclusion: URS in the SCI population is an effective treatment for ureteral or renal stones but may be associated with greater risks and reduced efficacy.Sponsorship: None.",
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Wolfe, T, Klausner, AP, Goetz, LL, King, AB, Hudson, T & Gater, D 2013, 'Ureteroscopy with laser lithotripsy for urolithiasis in the spinal cord injury population', Spinal Cord, vol. 51, no. 2, pp. 156-160. https://doi.org/10.1038/sc.2012.86

Ureteroscopy with laser lithotripsy for urolithiasis in the spinal cord injury population. / Wolfe, T.; Klausner, A. P.; Goetz, L. L.; King, A. B.; Hudson, T.; Gater, David.

In: Spinal Cord, Vol. 51, No. 2, 01.02.2013, p. 156-160.

Research output: Contribution to journalReview article

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T1 - Ureteroscopy with laser lithotripsy for urolithiasis in the spinal cord injury population

AU - Wolfe, T.

AU - Klausner, A. P.

AU - Goetz, L. L.

AU - King, A. B.

AU - Hudson, T.

AU - Gater, David

PY - 2013/2/1

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N2 - Study design: Retrospective study. Objectives: The purpose of this investigation was to review the outcomes and safety of retrograde ureteroscopic laser lithotripsy (URS) for the treatment of urolithiasis in the spinal cord injury (SCI) population. Setting: Virginia, USA. Methods: All patients with SCI who underwent URS with holmium: YAG laser lithotripsy for urolithiasis over a 15-year period were identified. Stone size, location and number at presentation were recorded. Information regarding patient characteristics, intra-operative complications, surgical efficacy, stone clearance, peri-operative complications, and follow-up stone events was collected and analyzed. Results: A total of 67 URS procedures were performed on 29 SCI patients during the study period with an average follow-up of 3.4 years. Patients had an average of 2.3 ipsilateral ureteroscopies. The majority (85.1%) used indwelling catheters for long-term bladder management, and complete stone clearance after the first procedure was 34.3%. Of the 44 cases with residual stones >4 mm, 20 (45.5%) were secondary to technical or procedural limitations. The intra-operative complication rate was comparable to non-SCI studies at 1.5%, but peri-operative complications were significantly higher at 29.9% with the majority due to urosepsis. Factors associated with peri-operative complications include chronic obstructive pulmonary disease, motor incomplete injuries and lack of a pre-operative ureteral stent. Conclusion: URS in the SCI population is an effective treatment for ureteral or renal stones but may be associated with greater risks and reduced efficacy.Sponsorship: None.

AB - Study design: Retrospective study. Objectives: The purpose of this investigation was to review the outcomes and safety of retrograde ureteroscopic laser lithotripsy (URS) for the treatment of urolithiasis in the spinal cord injury (SCI) population. Setting: Virginia, USA. Methods: All patients with SCI who underwent URS with holmium: YAG laser lithotripsy for urolithiasis over a 15-year period were identified. Stone size, location and number at presentation were recorded. Information regarding patient characteristics, intra-operative complications, surgical efficacy, stone clearance, peri-operative complications, and follow-up stone events was collected and analyzed. Results: A total of 67 URS procedures were performed on 29 SCI patients during the study period with an average follow-up of 3.4 years. Patients had an average of 2.3 ipsilateral ureteroscopies. The majority (85.1%) used indwelling catheters for long-term bladder management, and complete stone clearance after the first procedure was 34.3%. Of the 44 cases with residual stones >4 mm, 20 (45.5%) were secondary to technical or procedural limitations. The intra-operative complication rate was comparable to non-SCI studies at 1.5%, but peri-operative complications were significantly higher at 29.9% with the majority due to urosepsis. Factors associated with peri-operative complications include chronic obstructive pulmonary disease, motor incomplete injuries and lack of a pre-operative ureteral stent. Conclusion: URS in the SCI population is an effective treatment for ureteral or renal stones but may be associated with greater risks and reduced efficacy.Sponsorship: None.

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Wolfe T, Klausner AP, Goetz LL, King AB, Hudson T, Gater D. Ureteroscopy with laser lithotripsy for urolithiasis in the spinal cord injury population. Spinal Cord. 2013 Feb 1;51(2):156-160. https://doi.org/10.1038/sc.2012.86