EAU 2019: The Impact of Millimetric Residual Stones After Endourological Procedures for Treatment of Kidney Calculi: A Retrospective Analysis

Barcelona, Spain (UroToday.com) There is no uniform consensus on the best approach to residual stones, as it is known that these fragments have the potential to cause recurrence stones and complications. The aim of the current study presented by Dr. Nuno Morais and colleagues was to evaluate the characteristics and the natural history of residual stones after percutaneous nephrolithotomy (PCNL) or flexible ureterorenoscopy (F-URS) for treatment of kidney calculi.

Dr. Nuno Morais analyzed patients submitted to endoscopic procedures for the treatment of kidney stones. The presence and characteristics of residual fragments were accessed with a follow-up radiologic imaging and the occurrence of complications or the necessity of additional procedures.

The natural history of patients with residual fragments was the spontaneous passage in 10.8% of cases, 29.7% developed new symptoms, 31.3% had complications and 38.5% required a new surgical procedure. There was no correlation between spontaneous passage of residual calculi and its size. In the logistic regression models, the size of the residual fragments and the multi-calyceal distribution were predictors of the development of new symptoms and the need for surgical re-intervention. For each mm increase in the size of the residual stones the chance of having renal colic caused by a residual fragment increased significantly. It is important to note that the location in the upper calyx, the multi-calyceal distribution and the size of residual fragments were independent predictors of complications.

Dr. Nuno Morais summarized his talk that any residual fragments have the potential to cause morbidity and complications including renal colic, infectious complications, and recurrent interventions.

Presented by: Nuno De Sousa Morais, MD, Hospital de Braga, Department of Urology, Braga, Portugal 

Written by: Ekaterina Laukhtina, MD, Fellow, Institute for Urology and Reproductive Health, Sechenov University at the 34th European Association of Urology (EAU 2019) #EAU19 conference in Barcelona Spain, March 15-19, 2019.