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Surgical Management of Stone Disease in Patient with Primary Hyperoxaluria #MMPMID25733260
Urology 2015[Mar]; 85 (3): 522-6 PMID25733260show ga
Objectives: To present our experience with surgical management of nephrolithiasis in patients with primary hyperoxaluria (PH). Methods: A retrospective chart review from 1994?2012 was perform to identify patients with diagnosis of PH. Results: A total of 14 patients with PH were identified with median follow-up of 18.6 years (range: 0.9?51). Median age at initial symptom and subsequent diagnosis were 6.7 years (range: 1.1?35.5) and 0.42 years (range: 0?33.25), respectively. Patients underwent a total of 54 procedures at our institution including: ureteroscopy 27 (50%), percutaneous nephrolithotomy 15 (28%), shock wave lithotripsy 8 (15%), and combined procedures 4 (7%). Overall non-intraparenchymal stone free rate after first, second, and third procedure(s) were 59%, 76%, and 78%, respectively. On average 1.6 procedures (range: 1?4) were required to rid patients of symptomatic stones, which subsequently afforded them a mean of 3.62 years (range: 0.25?21.5) without the need of additional intervention. There were 6 Clavien grade ? III complications in 4 patients, including immediate postoperative ESRD in 3. Conclusions: Despite optimal medical and surgical management, patients experience recurrent acute stone events requiring multiple urologic interventions. Significant complications such as ESRD can occur secondary to surgical intervention.