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- Title
Ureteroscopic management in cystinuric patients: long-term results from a tertiary care referral center.
- Authors
Candela, Luigi; Chicaud, Marie; Solano, Catalina; Ventimiglia, Eugenio; Kutchukian, Stessy; Corrales, Mariela; Montorsi, Francesco; Salonia, Andrea; Panthier, Frederic; Doizi, Steeve; Haymann, Jean Philippe; Letavernier, Emmanuel; Daudon, Michel; Traxer, Olivier
- Abstract
Objective: To evaluate long-term surgical and functional outcomes of cystinuric patients exclusively treated with Ureteroscopy (URS). Methods: Data from patients treated for cystine stones at a single academic center were retrospectively analyzed. The management protocol consisted of (i) treating symptomatic or > 7 mm stones, (ii) multi-staged URS for voluminous stones, (iii) referring patients to a dedicated nephrological clinic. The eGFR was calculated according to the MDRD formula. CKD category was assessed according to the NKF classification. Relevant CKD was defined as CKD category ≥ 3a. Descriptive statistics were used to analyze the cohort data. Results: Data from 46 cystinuric patients treated with 332 URS were available. Median age at diagnosis and at first URS in our center were 18 and 32 years, respectively. Median follow-up was 101 months. Median number of URS and recurrences per patient were 6 and 2, respectively. The median interval between the first and the last available creatinine level was 64 months. Median first and last eGFR were 72 and 74 mL/min, respectively. Overall, 83% of patients had stable or improved renal function within the study period. Ureteral stricture occurred in 3 (6.5%) patients. Conclusions: Cystinuria requires intensive endoscopic management. Most patients treated with URS have stable or improved renal function within a long-term follow-up. CKD is a not neglectable event that potentially occurs at an early stage of life. Current findings should be considered for the surgical management of cystinuric patients.
- Subjects
URETEROSCOPY; URETERIC obstruction; TERTIARY care; ENDOSCOPIC surgery; KIDNEY physiology; DISEASE relapse
- Publication
World Journal of Urology, 2024, Vol 42, Issue 1, p1
- ISSN
0724-4983
- Publication type
Article
- DOI
10.1007/s00345-024-05067-1