Page 8 - CUA2019 Abstracts - Endourology

Poster session 3: Endourology

Only location “ureter below brim” was associated with increased success UP-3.5
in all models (odds ratio 1.50; 95% confidence interval 1.07–2.10). No Ultra-mini percutaneous nephrolithotomy (PCNL) for stones too
other variable was predictive. big for flexible ureterorenoscopy and too small for PCNL: An
Conclusions: Stones in the unsuccessful group were of higher mean axial early experience at a teaching hospital
density and trended towards higher volumetric density and larger volume. Keith Yuen , Adeel Anwar , Sachie Siriwardena , Jyoti Basu , Alistair
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1
2
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However, stone density distribution was not found to be predictive of Stewart , James Forster 1
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ESWL success. Among the variables examined, only stone location was 1 Urology, Bradford Royal Infirmary, Bradford, United Kingdom; Urology,
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associated with ESWL success. University Hospital Coventry, Coventry, United Kingdom
References Introduction: In the modern world, percutaneous nephrolithotomy (PCNL)
1. Yoshida S, Hayashi T, Ikeda J, et al. Role of volume and attenua- procedures are a popular mode of renal stone treatment. In order to
tion value histogram of urinary stone on non-contrast helical com- reduce the complication rates while maintaining high stone-free rates,
puted tomography as predictor of fragility by extracorporeal shock several new miniaturized PCNL techniques have been introduced. Here,
wave lithotripsy. Urology 2006;68:33-7. https://doi.org/10.1016/j. we are sharing our initial experience with ultra-mini percutaneous neph-
urology.2006.01.052 rolithotomy (UMP) for the stones too big for flexible ureterorenoscopy
2. Yamashita S, Kohjimoto Y, Iguchi T, et al. Variation coefficient of and too small for standard PCNL.
stone density: A novel predictor of the outcome of extracorporeal Method: We retrospectively evaluated all UMP carried out between 2016
shockwave lithotripsy. J Endourol 2017;31:384-90. https://doi. and 2018 at our centre. Patient demographics, stone burden, operative tech-
org/10.1089/end.2016.0719 niques, perioperative complications, and stone clearance were analyzed.
Results: Thirty-nine calculi were treated in 24 UMP procedures by three
UP-3.4 endourologists using sheath sizes 11 Fr or 14 Fr with a median of one
Patient search engine trends of common topics in nephrolithiasis: puncture per case. Mean index stone size was 11.5 mm (range 8 -25).
Evaluation of a novel method for assessment of patient interest Seventeen (71%) were “totally tubeless,” i.e., did not necessitate ure-
in endourology topics teric stent, catheter, or percutaneous nephrostomy. No blood transfusion
Luke Witherspoon , Brendan B. Wallace , Thomas A. Skinner , James was required for the cohort, and 22 (92%) experienced no perioperative
1
1
1
D. Watterson complications. The median length of stay was 1.2 days. One case was
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1 Department of Surgery - Division of Urology, University of Ottawa, abandoned due to the loss of access during UMP. Five patients were
Ottawa, ON, Canada readmitted within 30 days due to pain and infection. Twenty-two (92%)
Introduction: Kidney stone management is a vital component of any had complete stone clearance or insignificant residual stone at the time
urological practice, with patient education surrounding the prevention of planned postoperative surveillance.
and treatment being an essential aspect. It can be challenging to assess Conclusions: Our study demonstrates that UMP is a safe treatment option
specifics of what patients are interested in learning about and finding for renal stones up to 25 mm. It is particularly suited to patients who want
areas that patient education is deficient. In this study, we used Google to avoid a two-stage ureterorenoscopy and associated stent symptoms,
Trend data to assess common kidney stone terms and assess how patients and prefer a shorter hospital stay than traditional PCNL.
are investigating these topics online. References
Methods: We used Google Trends to assess common kidney stone search 1. Haghighi R, Zeraati H, Ghorban Zade M. Ultra-mini-percutaneous
topics, as they were searched between 2014 and 2018 in Canada. Google nephrolithotomy (PCNL) vs. standard PCNL: A randomized clini-
Trends is a free online service allowing analysis at a population level of cal trial. Arab J Urol 2017;15:294-8. https://doi.org/10.1016/j.
all search queries of a term or topic. Interest in a subject is condensed aju.2017.10.003
into a search volume index (SVI). SVI trends can be reported based on 2. Desai J, Zeng G, Zhao Z, et al. A novel technique of ultra-mini PCNL:
either time or geographic region. SVIs are normalized values with the Introduction and an initial experience for treatment of upper urinary
most popular time or geographic area being given a score of 100 out of calculi less than 2 cm. Biomed Res Int 2013;2013:490793. https://
100, with all other variables related to this value. doi.org/10.1155/2013/490793
Results: Of the search queries assessed, the top three geographic regions 3. Jones P, Elmussareh M, Aboumarzouk OM, et al. Role of minimally
(mean SVI ± standard deviation [(SD]) that were searching these top- invasive (micro and ultra-mini) PCNL for adult urinary stone disease
ics were Ontario (91.8±9.7), British Columbia (42.4±43.2), and Alberta in the modern era: Evidence from a systematic review. Curr Urol
(31.9±41.7). Interestingly, Ontario was the only province that showed Rep 2018;19:27. https://doi.org/10.1007/s11934-018-0764-5
interest in kidney stone surgery, kidney stone removal, or kidney stent.
The most researched topics in the past five years have been kidney stone
(66.1±13.1), kidney stone symptoms (34.2±17.3), and calcium oxalate
(32.1±14.8). Peak interest in these areas was November 2018, September
2015, and February 2017, respectively.
Conclusions: This study shows some of the first evidence that analysis
of online activity can help guide insight into the real-time interest of the
general public into topics in urology. Furthermore, it can help direct
educational materials both towards subjects that are not being assessed
by the general public, as well as geographic regions that show interest
in these topics.

CUAJ • June 2019 • Volume 13, Issue 6(Suppl5) S103