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01-09-2015 | Original Article

Impact of gender on success and complication rates after ureteroscopy

Authors: M. Özsoy, Ö. Acar, K. Sarica, Z. Saratlija-Novakovic, H. Fajkovic, D. Librenjak, T. Esen, N. Scheffbuch, C. Seitz

Published in: World Journal of Urology | Issue 9/2015

Abstract

Purpose

To investigate the impact of gender differences on treatment success, intraoperative and postoperative complications in patients undergoing ureteroscopy (URS).

Materials and methods

A prospectively maintained database of 927 consecutively performed ureteroscopies on solitary ureteral stones in four different centers was retrospectively analyzed. Stones were detected with preoperative computed tomography scans or intravenous urography imaging. Patients received intravenous antibiotics as perioperative prophylaxis. Patients with symptomatic urinary tract infections (UTI) prior to surgery were excluded. Follow-up was up to 2 weeks after URS or stent removal.

Results

Two hundred and eighty-six women and 641 men were included in this study. Mean stone size was 9 mm (range 2–35 mm). A double-J stent was placed in 240 (83 %) women and 527 (82 %) men at the end of surgery (p = 0.075). There was no significant gender difference in terms of stent dislocation (p = 0.239). Two hundred and fifty-one women (87 %) and 564 men (87 %) were stone-free after the first procedure (p = 0.917). Intraoperative complications were observed in 14 (4.8 %) women and 37 (5.9 %) men (p = 0.313). Severe UTI presenting with fever (>38 °C) and requiring prolonged hospitalization with parenteral antibiotics were observed in 11 (3 %) women and 8 (1 %) men postoperatively. This difference was statistically significant (p = 0.025).

Conclusion

No significant differences between female and male patients harboring ureteral stones with respect to intraoperative complications were detected. Although stone characteristics were comparable between groups, a small number of women had significantly more severe UTI’s postoperatively. Our current therapy regimen for URS seems to be efficient and safe both for females and males.

Seitz C, Fajkovic H (2013) Epidemiological gender-specific aspects in urolithiasis. World J Urol 31(5):1087–1092. doi:10.1007/s00345-013-1140-1 CrossRefPubMed

Delvecchio FC, Auge BK, Brizuela RM, Weizer AZ, Silverstein AD, Lallas CD, Pietrow PK, Albala DM, Preminger GM (2003) Assessment of stricture formation with the ureteral access sheath. Urology 61 (3):518–522; discussion 522

Preminger GM, Tiselius HG, Assimos DG, Alken P, Buck AC, Gallucci M, Knoll T, Lingeman JE, Nakada SY, Pearle MS, Sarica K, Turk C, Wolf JS Jr, American Urological Association E, Research I, European Association of U (2007) 2007 Guideline for the management of ureteral calculi. Eur Urol 52(6):1610–1631CrossRefPubMed

Yaycioglu O, Guvel S, Kilinc F, Egilmez T, Ozkardes H (2004) Results with 7.5F versus 10F rigid ureteroscopes in treatment of ureteral calculi. Urology 64 (4):643–646; discussion 646–647. doi:10.1016/j.urology.2004.05.050

Elashry OM, Elgamasy AK, Sabaa MA, Abo-Elenien M, Omar MA, Eltatawy HH, El-Abd SA (2008) Ureteroscopic management of lower ureteric calculi: a 15-year single-centre experience. BJU int 102(8):1010–1017. doi:10.1111/j.1464-410X.2008.07747.x CrossRefPubMed

Türk C, Knoll T, Petrik A, Sarica K, Skolarikos A, Straub M, Seitz C, Members of the European Association of Urology (EAU) Guidelines Office (2014) Guidelines on urolithiasis. In: EAU guidelines, edition presented at the 29th EAU annual congress, Stockholm. ISBN 978-90-79754-65-6

Geavlete P, Georgescu D, Nita G, Mirciulescu V, Cauni V (2006) Complications of 2735 retrograde semirigid ureteroscopy procedures: a single-center experience. J Endourol 20(3):179–185. doi:10.1089/end.2006.20.179 CrossRefPubMed

De La Rosette J, Denstedt JD, Geavlete PA, Keeley F, Matsuda T, Pearle MS, Preminger GM, Traxer O (2013) The clinical research office of the endourological society ureteroscopy global study: indications, complications, and outcomes in 11885 patients. J Endourol. doi:10.1089/end.2013.0436 PubMedCentral

El-Nahas AR, El-Tabey NA, Eraky I, Shoma AM, El-Hefnawy AS, El-Assmy AM, Soliman S, Youssef RF, El-Kenawy MR, Shokeir AA, El-Kappany HA (2009) Semirigid ureteroscopy for ureteral stones: a multivariate analysis of unfavorable results. J Urol 181(3):1158–1162. doi:10.1016/j.juro.2008.10.167 CrossRefPubMed

10.

Mandal S, Goel A, Singh MK, Kathpalia R, Nagathan DS, Sankhwar SN, Singh V, Singh BP, Sinha RJ, Dalela D (2012) Clavien classification of semirigid ureteroscopy complications: a prospective study. Urology 80(5):995–1001. doi:10.1016/j.urology.2012.05.047 CrossRefPubMed

11.

Anagnostou T, Tolley D (2004) Management of ureteric stones. Eur Urol 45(6):714–721. doi:10.1016/j.eururo.2003.10.018 CrossRefPubMed

12.

Grasso M (2000) Ureteropyeloscopic treatment of ureteral and intrarenal calculi. Urol Clin North Am 27(4):623–631CrossRefPubMed

13.

Strohmaier WL, Schubert G, Rosenkranz T, Weigl A (1999) Comparison of extracorporeal shock wave lithotripsy and ureteroscopy in the treatment of ureteral calculi: a prospective study. Eur Urol 36(5):376–379CrossRefPubMed

14.

Kurahashi T, Miyake H, Oka N, Shinozaki M, Takenaka A, Hara I, Fujisawa M (2007) Clinical outcome of ureteroscopic lithotripsy for 2,129 patients with ureteral stones. Urol Res 35(3):149–153. doi:10.1007/s00240-007-0095-3 CrossRefPubMed

15.

Fuganti PE, Pires S, Branco R, Porto J (2008) Predictive factors for intraoperative complications in semirigid ureteroscopy: analysis of 1235 ballistic ureterolithotripsies. Urology 72(4):770–774. doi:10.1016/j.urology.2008.05.042 CrossRefPubMed

16.

Sugihara T, Yasunaga H, Horiguchi H, Nishimatsu H, Kume H, Ohe K, Matsuda S, Fushimi K, Homma Y (2013) A nomogram predicting severe adverse events after ureteroscopic lithotripsy: 12,372 patients in a Japanese national series. BJU int 111(3):459–466. doi:10.1111/j.1464-410X.2012.11594.x CrossRefPubMed

17.

Martov A, Gravas S, Etemadian M, Unsal A, Barusso G, D’Addessi A, Krambeck A, de la Rosette J (2014) Postoperative infection rates in patients with a negative baseline urine culture undergoing ureteroscopic stone removal: a matched case-control analysis on antibiotic prophylaxis from the CROES URS global study. J Endourol. doi:10.1089/end.2014.0470

Title: Impact of gender on success and complication rates after ureteroscopy
Authors: M. Özsoy
Ö. Acar
K. Sarica
Z. Saratlija-Novakovic
H. Fajkovic
D. Librenjak
T. Esen
N. Scheffbuch
C. Seitz
Publication date: 01-09-2015
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 9/2015
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-014-1435-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Impact of gender on success and complication rates after ureteroscopy

Abstract

Purpose

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusion

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