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Long-term outcomes of percutaneous nephrolithotomy compared to shock wave lithotripsy and conservative management.
J Urol. 2008 Jun; 179(6):2233-7.JU

Abstract

PURPOSE

Percutaneous nephrolithotomy is successful at achieving stone-free status but long-term safety data are lacking. We report our long-term experience with percutaneous nephrolithotomy and compare these results with other treatment modalities.

MATERIALS AND METHODS

We identified 87 patients treated with percutaneous nephrolithotomy from 1983 to 1984 who continue to receive care at our institution. Retrospective chart review was performed. Long-term results were compared to those of a group of 288 patients with stones treated nonsurgically (controls) and a group of 288 patients treated with shock wave lithotripsy followed for 19 years.

RESULTS

Average followup was 19.2 years (range 12.7 to 23.0). After percutaneous nephrolithotomy new onset renal insufficiency was noted in 9 patients (10.6%), hypertension in 29 (34.1%), diabetes mellitus in 20 (23.5%) and ureteropelvic junction obstruction in 3 (3.5%). Stone recurrence occurred in 32 patients (36.8%). Recurrent stone events were associated with residual fragments after percutaneous nephrolithotomy (p = 0.049). Compared to shock wave lithotripsy there were no significant differences in the development of renal insufficiency, hypertension or diabetes mellitus. Stone recurrence was more common following shock wave lithotripsy (53.5%) compared to percutaneous nephrolithotomy (p = 0.033). Compared to controls there were no significant differences in the development of renal insufficiency or hypertension. On univariate analysis percutaneous nephrolithotomy was associated with the development of diabetes mellitus (p <0.001) but this association did not persist in multivariate analysis.

CONCLUSIONS

At 19 years of followup stone recurrences were less frequent following percutaneous nephrolithotomy compared to shock wave lithotripsy. Recurrent stone events were associated with residual fragments after percutaneous nephrolithotomy. Percutaneous nephrolithotomy was not associated with the development of adverse medical conditions compared to shock wave lithotripsy or conservatively managed stone cases.

Authors+Show Affiliations

Department of Urology, Mayo Medical School and Mayo Clinic, Rochester, Minnesota 55906, USA. Krambeck.amy@mayo.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

18423676

Citation

Krambeck, Amy E., et al. "Long-term Outcomes of Percutaneous Nephrolithotomy Compared to Shock Wave Lithotripsy and Conservative Management." The Journal of Urology, vol. 179, no. 6, 2008, pp. 2233-7.
Krambeck AE, LeRoy AJ, Patterson DE, et al. Long-term outcomes of percutaneous nephrolithotomy compared to shock wave lithotripsy and conservative management. J Urol. 2008;179(6):2233-7.
Krambeck, A. E., LeRoy, A. J., Patterson, D. E., & Gettman, M. T. (2008). Long-term outcomes of percutaneous nephrolithotomy compared to shock wave lithotripsy and conservative management. The Journal of Urology, 179(6), 2233-7. https://doi.org/10.1016/j.juro.2008.01.115
Krambeck AE, et al. Long-term Outcomes of Percutaneous Nephrolithotomy Compared to Shock Wave Lithotripsy and Conservative Management. J Urol. 2008;179(6):2233-7. PubMed PMID: 18423676.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term outcomes of percutaneous nephrolithotomy compared to shock wave lithotripsy and conservative management. AU - Krambeck,Amy E, AU - LeRoy,Andrew J, AU - Patterson,David E, AU - Gettman,Matthew T, Y1 - 2008/04/18/ PY - 2007/10/18/received PY - 2008/4/22/pubmed PY - 2008/6/3/medline PY - 2008/4/22/entrez SP - 2233 EP - 7 JF - The Journal of urology JO - J. Urol. VL - 179 IS - 6 N2 - PURPOSE: Percutaneous nephrolithotomy is successful at achieving stone-free status but long-term safety data are lacking. We report our long-term experience with percutaneous nephrolithotomy and compare these results with other treatment modalities. MATERIALS AND METHODS: We identified 87 patients treated with percutaneous nephrolithotomy from 1983 to 1984 who continue to receive care at our institution. Retrospective chart review was performed. Long-term results were compared to those of a group of 288 patients with stones treated nonsurgically (controls) and a group of 288 patients treated with shock wave lithotripsy followed for 19 years. RESULTS: Average followup was 19.2 years (range 12.7 to 23.0). After percutaneous nephrolithotomy new onset renal insufficiency was noted in 9 patients (10.6%), hypertension in 29 (34.1%), diabetes mellitus in 20 (23.5%) and ureteropelvic junction obstruction in 3 (3.5%). Stone recurrence occurred in 32 patients (36.8%). Recurrent stone events were associated with residual fragments after percutaneous nephrolithotomy (p = 0.049). Compared to shock wave lithotripsy there were no significant differences in the development of renal insufficiency, hypertension or diabetes mellitus. Stone recurrence was more common following shock wave lithotripsy (53.5%) compared to percutaneous nephrolithotomy (p = 0.033). Compared to controls there were no significant differences in the development of renal insufficiency or hypertension. On univariate analysis percutaneous nephrolithotomy was associated with the development of diabetes mellitus (p <0.001) but this association did not persist in multivariate analysis. CONCLUSIONS: At 19 years of followup stone recurrences were less frequent following percutaneous nephrolithotomy compared to shock wave lithotripsy. Recurrent stone events were associated with residual fragments after percutaneous nephrolithotomy. Percutaneous nephrolithotomy was not associated with the development of adverse medical conditions compared to shock wave lithotripsy or conservatively managed stone cases. SN - 1527-3792 UR - https://www.unboundmedicine.com/medline/citation/18423676/Long_term_outcomes_of_percutaneous_nephrolithotomy_compared_to_shock_wave_lithotripsy_and_conservative_management_ L2 - https://www.jurology.com/doi/full/10.1016/j.juro.2008.01.115?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -