Surgical management of stone disease in patients with primary hyperoxaluria.

Abstract:

OBJECTIVE:To present our experience with surgical management of nephrolithiasis in patients with primary hyperoxaluria (PH). METHODS:A retrospective chart review from 1994 to 2012 was performed to identify patients with diagnosis of PH. RESULTS:A total of 14 patients with PH were identified with a median follow-up of 18.6 years (range, 0.9-51 years). Median ages at initial symptom and subsequent diagnosis were 6.7 years (range, 1.1-35.5 years) and 0.42 years (range, 0-33.25 years), respectively. Patients underwent a total of 54 procedures at our institution, including ureteroscopy (27 [50%]), percutaneous nephrolithotomy (15 [28%]), shock wave lithotripsy (8 [15%]), and combined procedures (4 [7%]). Overall nonintraparenchymal stone-free rate after the first, second, and third procedures were 59%, 76%, and 78%, respectively. On average, 1.6 procedures (range, 1-4) were required to rid patients of symptomatic stones, which subsequently afforded them a mean of 3.62 years (range, 0.25-21.5 years) without the need for additional intervention. There were 6 Clavien grade ≥III complications in 4 patients, including immediate postoperative end-stage renal disease in 3 patients. CONCLUSION:Despite optimal medical and surgical management, patients experience recurrent acute stone events requiring multiple urologic interventions. Significant complications such as end-stage renal disease can occur secondary to surgical intervention.

journal_name

Urology

journal_title

Urology

authors

Carrasco A Jr,Granberg CF,Gettman MT,Milliner DS,Krambeck AE

doi

10.1016/j.urology.2014.11.018

subject

Has Abstract

pub_date

2015-03-01 00:00:00

pages

522-6

issue

3

eissn

0090-4295

issn

1527-9995

pii

S0090-4295(14)01307-7

journal_volume

85

pub_type

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