Premium
Management of urolithiasis in patients after urinary diversions
Author(s) -
Okhunov Zhamshid,
Duty Brian,
Smith Arthur D.,
Okeke Zeph
Publication year - 2011
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2011.10194.x
Subject(s) - medicine , percutaneous nephrolithotomy , urinary system , percutaneous , lithotripsy , surgery , upper urinary tract , urinary diversion , general surgery , cystectomy , bladder cancer , cancer
What’s known on the subject? and What does the study add? Patients undergoing urinary diversion are at increased risk of stone formation in the upper urinary tract and within the pouch. Several studies have reported wide ranging outcomes of the various surgical and non‐surgical management options. In this article we reviewed risk factors, etiology, and outcomes of surgical and medical management of diversion‐associated urolithiasis. A surgical management algorithm was developed based on the known literature to serve as a guide to treatment stones in these patients. The relative effectiveness of various preventive management strategies are reviewed and summarized. After urinary diversion patients are at increased risk of long‐term complications, including stones of the upper urinary tract and reservoir or conduit. Advances in instrumentation and techniques have expanded treatment options, while minimizing morbidity. Minimally invasive treatment methods include shockwave lithotripsy, antegrade and retrograde ureteroscopic lithotripsy and percutaneous nephrolithotomy. Percutaneous and laparoscopic techniques are applicable to stones within urinary diversions. Medical management is crucial for avoiding recurrent stones in these patients.