Risk factors of calculi in upper urinary tract after radical cystectomy with urinary diversion.

Abstract:

INTRODUCTION AND OBJECTIVES:The study was conducted to identify the risk factors of upper tract stone formation in patients with diversions after radical cystectomy (RC). MATERIALS AND METHODS:All patients with diversion after RC were collected in our center from January 2005 to December 2013. Three different common diversions were included: Orthotopic neobladder (ON: 168 patients), Ileal Conduit (IC: 93 patients) or Ureterocutaneostomy (UC: 104 patients). Univariable and multivariable logistic regression analysis were conducted to identify the independent predictors of stone formation in the upper tract. RESULTS:A total of 365 consecutive patients (316 males, 49 females) were included. At a median follow-up of 48 months (range 12-65 months), 36 patients (9.9%) developed upper tract stone. Among them, 26 (72.2%), 5 (13.9%) and 5 (13.9%) patients underwent ON, IC and UC, respectively. 25 patients had renal stone and 11 ureter stone. Minimally invasive operations (endoscopic laser lithotripsy via the anterograde or retrograde approach in 24 cases, percutaneous nephrolithotomy in 9 cases and shock wave lithotripsy in 3 cases) were carried out successfully in all stone cases. On univariable and multivariable logistic regression analysis, diabetes mellitus, hypertension, urinary tract infection (UTI), anastomotic stenosis and types of diversions (P<.05) were positively associated with upper tract stone formation. CONCLUSIONS:The variable predictors of upper tract stone may contain diabetes mellitus, hypertension, UTI, anastomotic stenosis and types of diversion.

journal_name

Actas Urol Esp

authors

Zhang B,Xie H,Liu C

doi

10.1016/j.acuro.2019.04.002

subject

Has Abstract

pub_date

2019-12-01 00:00:00

pages

568-572

issue

10

eissn

0210-4806

issn

1699-7980

pii

S0210-4806(19)30102-0

journal_volume

43

pub_type

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