Characterization of Urolithiasis in Patients Following Lower Urinary Tract Reconstruction with Intestinal Segments

Tracy Marien, Jennifer Robles, Trisha M. Kammann, Mustafa Kadihasanoglu, Davis P. Viprakasit, S. Duke Herrell, Nicole L. Miller

Research output: Contribution to journalReview article

  • 2 Citations

Abstract

Purpose: Urinary diversion and augmentation cystoplasty are associated with long-term complications, including metabolic derangements, infectious complications, and urolithiasis. The aim of this series was to characterize upper and lower urinary tract (LUT) calculi in this population. Methods: A retrospective chart review was performed on all patients with a history of urinary diversion or augmentation cystoplasty who subsequently underwent treatment for urolithiasis between January 1998 and May 2015. Data collected included demographics, perioperative characteristics, type of reconstructive procedure, urine culture, stone analysis, and metabolic evaluation. A statistical analysis was performed. Results: Ninety-nine patients were identified with a history of urolithiasis and incontinent urinary diversion (28), neobladder (21), continent cutaneous diversion (12), and augmentation cystoplasty (38). LUT stones were more common than upper tract stones in all except for incontinent diversions, which only had one lower tract stone (p = 0.0001). Twenty-three percent of stones were metabolic. Several metabolic derangements were noted, including hypocitraturia (100%), elevated urine pH (100%), low urine volume (70%), and hyperoxaluria (35%). There was a 44% rate of recurrent urolithiasis. Conclusions: Given the high rate of stone recurrence among patients with a history of urinary diversion and augmentation cystoplasty, all measures should be taken to prevent recurrent stones. In addition to actions aimed to prevent infectious stones such as bladder and pouch irrigation, we recommend these patients undergo a full metabolic workup with targeted dietary changes and medical therapies.

LanguageEnglish (US)
Pages217-222
Number of pages6
JournalJournal of Endourology
Volume31
Issue number3
DOIs
StatePublished - Mar 1 2017

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Urinary Diversion
Urolithiasis
Urinary Tract
Urinary Calculi
Urine
Hyperoxaluria
Urinary Bladder
Demography
Recurrence
Skin
Therapeutics
Population

Keywords

  • augmentation cystoplasty
  • bladder stone
  • kidney stones
  • urinary diversion
  • urolithiasis

ASJC Scopus subject areas

  • Urology

Cite this

Marien, T., Robles, J., Kammann, T. M., Kadihasanoglu, M., Viprakasit, D. P., Herrell, S. D., & Miller, N. L. (2017). Characterization of Urolithiasis in Patients Following Lower Urinary Tract Reconstruction with Intestinal Segments. Journal of Endourology, 31(3), 217-222. DOI: 10.1089/end.2016.0297

Characterization of Urolithiasis in Patients Following Lower Urinary Tract Reconstruction with Intestinal Segments. / Marien, Tracy; Robles, Jennifer; Kammann, Trisha M.; Kadihasanoglu, Mustafa; Viprakasit, Davis P.; Herrell, S. Duke; Miller, Nicole L.

In: Journal of Endourology, Vol. 31, No. 3, 01.03.2017, p. 217-222.

Research output: Contribution to journalReview article

Marien, T, Robles, J, Kammann, TM, Kadihasanoglu, M, Viprakasit, DP, Herrell, SD & Miller, NL 2017, 'Characterization of Urolithiasis in Patients Following Lower Urinary Tract Reconstruction with Intestinal Segments' Journal of Endourology, vol 31, no. 3, pp. 217-222. DOI: 10.1089/end.2016.0297
Marien T, Robles J, Kammann TM, Kadihasanoglu M, Viprakasit DP, Herrell SD et al. Characterization of Urolithiasis in Patients Following Lower Urinary Tract Reconstruction with Intestinal Segments. Journal of Endourology. 2017 Mar 1;31(3):217-222. Available from, DOI: 10.1089/end.2016.0297
Marien, Tracy ; Robles, Jennifer ; Kammann, Trisha M. ; Kadihasanoglu, Mustafa ; Viprakasit, Davis P. ; Herrell, S. Duke ; Miller, Nicole L./ Characterization of Urolithiasis in Patients Following Lower Urinary Tract Reconstruction with Intestinal Segments. In: Journal of Endourology. 2017 ; Vol. 31, No. 3. pp. 217-222
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