Open Access

ARTICLE

Effect of stone composition on surgical stone recurrence: single center longitudinal analysis

Shuang Li¹, Viacheslav Iremashvili², Simone L. Vernez¹, Kristina L. Penniston¹, R. Allan Jhagroo³, Sara L. Best¹, Sean P. Hedican¹, Stephen Y. Nakada¹

1 Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
2 United Hospital Center, Bridgeport, West Virginia, USA
3 Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
Address correspondence to Dr. Shuang Li, Department of Urology, University of Wisconsin School of Medicine and PublicHealth,MedicalFoundationCentennialBuilding,1685 Highland Avenue, Madison, WI 53705 USA

Canadian Journal of Urology 2021, 28(4), 10744-10749.

Abstract

Introduction: The objective of this study is to explore the association between urinary stone composition and surgical recurrence.
Materials and methods: Patients who underwent kidney stone surgeries (between 2009-2017), were followed for > 1 year, and had ≥ 1 stone composition analyses were included in our analysis. Surgical stone recurrence (repeat surgery) was defined as the second surgery on the same kidney unit. Recurrence-free survival analysis was used.
Results: A total number of 1051 patients were included (52.7% men, average age 59.1 ± 15.1 years). Over 4.7 ± 2.5 years follow-up, 26.7% of patients required repeat surgery. Patients’ stone compositions were calcium oxalate (66.0%), uric acid (12.2%), struvite (10.0%), brushite (5.7%), apatite (5.1%), and cystine (1.0%). Results suggested that patients with cystine stones had the highest surgical recurrence risk; brushite had the second-highest surgical recurrence risk. Struvite, uric acid, and apatite stones were at higher risk compared with calcium oxalate stones (lowest risk in our cohort). When pre- and postoperative stone size was controlled, patients with a history of uric acid, brushite, and cystine stones were at higher surgical risk. After controlling clinical and demographic factors, only brushite and cystine stones were associated with higher surgical recurrence.
Conclusions: Patients with cystine stones had the highest surgical recurrence risk; brushite stones had the second-highest surgical recurrence risk. Struvite, uric acid, and apatite stones were at higher risk compared with calcium oxalate stones. When pre- and postoperative stone size, clinical, and demographic factors were controlled, only those with brushite or cystine stones were at significantly higher risk of surgical recurrence.

---

Keywords

---