Introduction Although ureteroscopy (URS) has been established as a viable treatment for stones in obese patients, the safety and success has not be fully elucidated. The current study describes the worldwide prevalence of obesity in patients with urolithiasis and examines trends in URS outcomes, safety and efficacy. Methods This study utilized the CROES URS Global Study which was a prospective, multicentre study including 11,885 patients treated with URS for urinary stones at 1 of 114 urology departments across 32 countries. The relationship between BMI, diabetes and creatinine, with retreatment, stone free rates, complications, and long hospital stay, was examined with a multivariate logistic regression analyses. Results Of the 10,099 URS patients with BMI data, 17.4% were obese and 2.2% super obese. Overall 86.7% were stone free and 16.8% required retreatment. Higher BMI was associated with lower stone free rates and any deviation from normal weight, was associated with higher retreatment rates. In multivariate analysis controlling for several variables including stone size the association between BMI and lower stone free rates with higher retreatment rates persisted. Intraoperative complications occurred in 518 (5.1%) patients and 343 (3.4%) experienced a postoperative complication. Post-operative complications were more frequent in the underweight and super obese subjects and there was no relationship of BMI with intra-operative complications. Discussion Although URS for stone disease was found to be an overall safe procedure for obese and super obese patients, efficacy of the procedure may be lower compared to normal weight subjects and higher retreatment rates may be necessary.
Journal of endourology. 2016 Oct 31 [Epub ahead of print]
Amy E Krambeck, Nienke J Wijnstok, Peter Olbert, George Mitroi, Simon Bariol, Hemendra Navinchandra Shah, Ahmed El-Abd, Bulent Onal, Jean De La Rosette
Indiana University Health, 22529, Indianapolis, Indiana, United States ; ., AMC University Hospital, Urology, Amsterdam, Netherlands ; ., University Medical Center, Urology, Marburg, Germany ; ., SCJU Craiova, Urology, Craiova, Romania ; ., Westmead Hospital and University of Sydney, Sydney, Australia ; ., S. L. Raheja (Fortis associate) hospital, Mumbai, India ; ., Tanta University, 68781, Tanta, Egypt ; ., Istanbul University Cerrahpasa School of Medicine, Urology , Osmaniye Fildami Araligi Sok., Fildami Sitesi , A-Blok, No: 20 , Istanbul, Turkey , 34144., AMC University Hospital, Amsterdam, Netherlands ; .