Page 2 - CUA 2020_Endourology

2020 CUA Abstracts

POD-1.1. Table 1B. Number of subjects with urologic events by year 1 (adjudicated by CEC)
Treatment
Aquablation TURP
Event summary n Rate per 100 n Rate per 100 p*
Bladder neck contracture 3 2.6 1 1.5 1
Bladder pain/spasm 7 6 3 4.6 1
Bleeding 17 14.7 10 15.4 1.0000
Decreased libido 0 0 1 1.5 0.3591
Dysuria 15 12.9 6 9.2 0.6293
Erectile dysfunction 0 0 1 1.5 0.3591
Non-urological 2 1.7 4 6.2 0.1898
Pain 8 6.9 4 6.2 1.0000
Penile edema 1 0.9 0 0 1
Penile trauma 1 0.9 0 0 1
Prostate cancer 0 0 1 1.5 0.3591
Retrograde ejaculation 8 6.9 17 26.2 0.0006
Stricture or adhesions 3 2.6 3 4.6 0.6684
Swollen testicles 0 0 1 1.5 0.3591
Urethral damage 1 0.9 1 1.5 1
Urinary retention 10 8.6 7 10.8 0.6085
Urinary tract infection 13 11.2 8 12.3 0.8133
Urinary tract stones 0 0 2 3.1 0.1277
Urinary urgency/frequency/difficulty/ 20 17.2 9 13.8 0.6740
leakage
*Fisher’s test p value.

POD-1.2 Conclusions: The incidence of surgically treated PUL is stable over 15
Surgical trends in pediatric urolithiasis management in Ontario years in Ontario, Canada. URS has become the most common surgical
from 2002–2016 treatment modality for PUL and ESWL rates have dropped, possibly sec-
1
1
Fernanda Gabrigna Berto , Zhan Tao (Peter) Wang , Jennifer Bjazevic , ondary to the higher rates of re-do surgical intervention.
1
1
2
Guido Filler , Blayne K. Welk , Hassan Razvi , Sumit Dave 1 References
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2
1 Urology, University of Western Ontario, London, ON, Canada; Pediatric 1. Alfandary H, Haskin O, Davidovits M, et al. Increasing prevalence
Nephrology, University of Western Ontario, London, ON, Canada of nephrolithiasis in association with increased body mass index in
Introduction: A global increase in pediatric urolithiasis (PUL) incidence children: A population-based study. J Urol 2018;199:1044-9. https://
has been reported. As a potentially recurrent condition, PUL has doi.org/10.1016/j.juro.2017.10.023
1-5
implications on morbidity and healthcare costs. This study evaluates 2. Park HK, Kim JH, Min GE, et al. Change of trends in the treatment
7
5,6
surgical trends and outcomes of PUL in Ontario over a 15 year-period modality for pediatric nephrolithiasis: Retrospective analysis of a
(2002–2016). U.S.-based insurance claims database. J Endourol 2019;33:614-8.
Methods: This retrospective cohort study used administrative databases https://doi.org/10.1089/end.2019.0154
held at the Institute of Clinical Evaluative Sciences to identify all children 3. Sas DJ, Hulsey TC, Shatat IF, et al. Increasing incidence of kidney
(<18 years) who underwent their first surgical treatment for PUL using the stones in children evaluated in the emergency department. J Pediatr
Canadian Institute for Health Information-Discharge Abstract Database 2010;157:132-7. https://doi.org/10.1016/j.jpeds.2010.02.004
and ICD10th revision. Stone location and treatment modality were simul- 4. Matlaga BR, Schaeffer AJ, Novak TE, et al. Epidemiologic insights
taneously identified. Descriptive statistics were used to summarize patient into pediatric kidney stone disease. Urol Res 2010;38:453-7. https://
demographics and surgical trends. Logistic regression analysis was per- doi.org/10.1007/s00240-010-0327-
formed to identify independent risk factors for repeat surgical intervention 5. Routh JC, Graham DA, Nelson CP. Epidemiological trends in pedi-
within six months of index procedure. atric urolithiasis at United States freestanding pediatric hospitals. J
Results: A total of 706 patients undergoing surgical procedure for PUL Urol 2010;184:1100-4. https://doi.org/10.1016/j.juro.2010.05.018
were identified (mean age 12.6±4.8 years); 68.5% of children were older 6. Schaeffer AJ, Feng Z, Trock BJ, et al. Medical comorbidities associ-
than 12 years and 55.2% presented with ureteric stones. There was no ated with pediatric kidney stone disease. Urology 2011;77:195-9.
statistical increase in the number of procedures performed, gender pre- https://doi.org/10.1016/j.urology.2010.06.062
dominance, or age difference at surgery. Ureteroscopy (URS) was the most 7. Kusumi K, Becknell B, Schwaderer A. Trends in pediatric urolithiasis:
commonly performed procedure (63.7%) and its application increased Patient characteristics, associated diagnoses, and financial burden.
over time (p<0.0001) (Fig. 1). Conversely, extracorporeal shockwave litho- Pediatr Nephrol 2015;30:805-10. https://doi.org/10.1007/s00467-
tripsy (ESWL) use decreased. Percutaneous nephrolithotripsy rates (9.6%) 014-3012-3
were stable. Renal stone location (odds ratio [OR] 2.79; p=0.0002) and
ESWL (OR 1.66; p=0.0025) were independent risk factors for repeat surgi-
cal procedure within six months. Stone recurrence requiring additional
surgery after five years was 33%.
S24 CUAJ • June 2020 • Volume 14, Issue 6(Suppl2)