Objective: Surgical treatment of kidney stones in the obese patient (BMI > 30 kg/m2) remains challenging as shockwave lithotripsy may not be an option due to weight limitations.
We sought to determine the effectiveness of ureteroscopic laser lithotripsy in obese patients compared to non-obese controls.
Patients and Methods: Patients from 2004 to 2007 were retrospectively analyzed providing a group of 292 patients (163 obese, 76 overweight, 53 normal) who underwent ureteroscopic procedures for urolithiasis at four centres in the US and Canada.
Results: The percentage of obese patients requiring flexible ureteroscopy (79%) was higher than in the other groups (P< 0.0001). Flexible ureteroscopy was associated with a lower stone free rate on multivariate analysis (p=0.034). There was no difference in stone free rates of patients who required a ureteral access sheath, basket extraction, or received a post-operative stent. Complication rates did not differ between groups.
Conclusion: Stone free rates using ureteroscopic lithotripsy in obese and overweight populations are the same as in the normal weight patients. A flexible ureteroscope was associated with a decreased stone free rate, but this likely due to a more proximal stone location in these patients. Ureteroscopic laser lithotripsy is an effective and safe technique to treat urolithiasis in the overweight/obese patient.
Written by:
Chew B, Zavaglia B, Paterson RF, Teichman JM, Lange D, Zappavigna C, Matlaga BR, Nunez-Nateras R, Bruhn A, Altamar HO, Humphreys MR, Shah O, Miller NL. Are you the author?
University of British Columbia, Urologic Sciences, Level 6, 2775 Laurel st., Vancouver, British Columbia, Canada, V5Z 1M9, 604-875-5003, Canada;
Reference: J Endourol. 2013 Mar 22. Epub ahead of print.
doi: 10.1089/end.2012.0605
PubMed Abstract
PMID: 23521213
UroToday.com Endourology Section
