[Effect of the body mass index on outcomes of ureterorenoscopy for renal stones]

Urologe A. 2016 Nov;55(11):1462-1469. doi: 10.1007/s00120-016-0132-3.
[Article in German]

Abstract

Background: Purpose of this work is to compare the outcome of ureterorenoscopy (URS) with regard to stone-free rates (SFR) and complication rates (CR) in patients with different body mass index (BMI) scores for the treatment of kidney stones.

Materials and methods: A retrospective chart review of all patients with known BMI, who underwent URS for kidney stones between 2006 and 2012 at our institution, was performed (n = 556 patients). The SFR and CR of obese patients were compared to overweight and normal weight patients.

Results: Mean age was 52.51 years and the average BMI 27.74 kg/m2. Of the patients, 34.2 % had normal weight (22.59 ± 1.91 kg/m2), 39.6 % were overweight (27.30 ± 1.42 kg/m2), and 26.3 % were obese (35.09 ± 5.93 kg/m2). The mean ASA score differed significantly between normal weight (1.99 ± 0.57), overweight (2.03 ± 0.62), and obese (2.22 ± 0.63) patients (p ≤ 0.036). The mean stone size was 8.51 ± 6.84 mm and the mean number of stones per patient 1.9 ± 2.41, whereby the differences between groups was not significant. There were no differences between the groups regarding the use of preoperative (94.8 %) and postoperative ureteral stents (60.3 %), the Ho:YAG laser (33.6 %), the use of flexible (16.2 %) or semirigid/flexible URS (59.4 %), and the mean operative time (52.04 ± 34.55 min). There were no differences in the SFR for the upper (90 %), mid (94.7 %), and lower pole (90.2 %), multiple location (68.6 %) or the total SFR (86.3 %). Total SFR of 95.7, 88.4, and 73.7 % for urinary calculi < 5 mm, 5-9 mm, and ≥ 10 mm, respectively, were found and the differences between the patient groups was not significant. The CR was 10.4 % (differences between the patient groups not significant).

Conclusion: URS is an appropriate treatment for renal stones with high SFR and low CR regardless of patient's BMI.

Keywords: Clavien classification; Complication rate; Nephrolithiasis; Obesity; Stone free rate.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Body Mass Index*
  • Child
  • Comorbidity
  • Female
  • Germany / epidemiology
  • Humans
  • Kidney Calculi / epidemiology*
  • Kidney Calculi / pathology
  • Kidney Calculi / surgery*
  • Male
  • Middle Aged
  • Obesity / diagnosis
  • Obesity / epidemiology*
  • Obesity / surgery*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / prevention & control*
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome
  • Ureteroscopy / statistics & numerical data*
  • Young Adult