Article

The purpose of this investigation was
to review the outcomes and safety of retrograde ureteroscopic laser lithotripsy
(URS) for the treatment of urolithiasis in the spinal cord injury (SCI)
population.Setting:Virginia, USA. Methods : All patients with SCI who underwent URS
with holmium:YAG laser lithotripsy for urolithiasis over a 15-year period were
identified. Stone size, location and number at presentation were recorded.
Information regarding patient characteristics, intra-operative complications,
surgical efficacy, stone clearance, peri-operative complications, and follow-up
stone events was collected and analyzed.Results:A total of 67 URS procedures were
performed on 29 SCI patients during the study period with an average follow-up of
3.4 years. Patients had an average of 2.3 ipsilateral ureteroscopies. The
majority (85.1%) used indwelling catheters for long-term bladder management, and
complete stone clearance after the first procedure was 34.3%. Of the 44 cases
with residual stones >4 mm, 20 (45.5%) were secondary to technical or procedural
limitations. The intra-operative complication rate was comparable to non-SCI
studies at 1.5%, but peri-operative complications were significantly higher at
29.9% with the majority due to urosepsis. Factors associated with peri-operative
complications include chronic obstructive pulmonary disease, motor incomplete
injuries and lack of a pre-operative ureteral stent.Conclusion:URS in the SCI
population is an effective treatment for ureteral or renal stones but may be
associated with greater risks and reduced efficacy.Sponsorship:None.

Langue : ANGLAIS