Children With Spinal Abnormalities Have an Increased Health Burden From Upper Tract Urolithiasis

Ramachandra, Puneeta; Palazzi, Kerrin; Holmes, Nicholas M.; Chiang, George

doi:10.1016/j.urology.2013.12.050

Cited by 14 publications

(7 citation statements)

References 9 publications

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“…Urolithiasis is a common condition in patients with spinal deformities, especially in patients with neurogenic voiding dysfunction. 1,5 Two of our patients had voiding dysfunction as a consequence of spina bifida. Two patients had hypercalcemia and one had struvite stone due to chronic urinary infection.…”

Section: Discussionmentioning

confidence: 88%

Retrograde intrarenal surgery by flexible ureteroscope in patients with spinal deformities

Polat

Yeşil

2016

The Journal of Spinal Cord Medicine

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Section: Discussionmentioning

confidence: 88%

Retrograde intrarenal surgery by flexible ureteroscope in patients with spinal deformities

Polat

Yeşil

2016

The Journal of Spinal Cord Medicine

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“…Ramachandra et al reviewed the upper tract stone population with vs without SB from 2004 to 2011 in the PHIS (Pediatric Health Information Systems) database. 6 They similarly found that patients with SB who had upper tract stones showed twice the median cost per admission and were at twice the risk for repeat stone procedures.…”

Section: Discussionmentioning

confidence: 92%

Complications of Surgical Management of Upper Tract Calculi in Spina Bifida Patients: Analysis of Nationwide Data

et al. 2015

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Purpose The management of upper urinary tract stones in patients with spina bifida is challenging but poorly described in the literature. We compared urolithiasis interventions and related complications in patients with spina bifida to those in other stone formers using a national database. Materials and Methods We retrospectively reviewed the NIS to identify hospital admissions for renal and ureteral stones from 1998 to 2011. We used ICD-9-CM codes to identify urological interventions, including shock wave lithotripsy, ureteroscopy, percutaneous nephrolithotomy and ureteral stent placement. NSQIP data were used to identify postoperative complications. Results We identified 4,287,529 weighted stone hospital admissions, including 12,315 (0.3%) of patients with spina bifida. Compared to those without spina bifida the patients with spina bifida who had urolithiasis were significantly younger (mean age 34 vs 53 years), more likely to have public insurance (72% vs 44%) and renal vs ureteral calculi (81% vs 58%), and undergo percutaneous nephrolithotomy (27% vs 8%). After adjusting for age, insurance, comorbidity, treatment year, surgery type, stone location and hospital factors patients with spina bifida were more likely to have urinary tract infections (OR 2.5), urinary complications (OR 3.1), acute renal failure (OR 1.9), respiratory complications (OR 2.0), pneumonia (OR 1.5), respiratory insufficiency (OR 3.2), prolonged mechanical ventilation (OR 3.2), sepsis (OR 2.7), pulmonary embolism (OR 3.0), cardiac complications (OR 2.4) and bleeding (OR 1.6). Conclusions Compared to those without spina bifida the patients with spina bifida who were hospitalized for urolithiasis were younger, and more likely to have renal stones and undergo percutaneous nephrolithotomy. Urolithiasis procedures in patients with spina bifida were associated with a significantly higher risk of in-hospital postoperative complications.

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“…Likely mechanisms for this predisposition to upper tract urolithiasis include immobility (with resultant bone resorption), bacteriuria, and urinary stasis. [4] The bladder is a hollow muscular organ whose function is to store urine to about 400-500 mL in adults and to void as a consequence of a consequence of a filling stimulus. The micturition cycle is the continuous event of storing and voiding of urine.…”

Section: The Bladder and Manifestations Associated With Spina Bifidamentioning

confidence: 99%

Urologic Implications and Management in Spina Bifida

Gutiérrez-González¹,

Robles-Torres²,

García-Sánchez³

2021

Spina Bifida and Craniosynostosis - New Perspectives and Clinical Applications

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Urological disorders, including urinary infections, incontinence, and renal failure, represent a significant source of morbidity and mortality in these patients. Long-term mortality is associated to urological causes in approximately 33%. In order to prevent this complications, urologic evaluation since early childhood must be done. The evaluation of the degree of damage to the urinary tract and the determination of the type of neurogenic bladder involved in the spina bifida spectrum will be the guideline for establishing therapeutic management, which can be from behavioral modifications, medical management, minimally invasive therapy and, as a last resort, surgery. In this chapter, we will discuss the wide spectrum of urologic implications, a brief reminder of urinary tract physiology and the pathological processes involved in spina bífida, as well as long-term complications. The diagnostic evaluation of urinary tract and the different therapeutic modalities according to the type of neurogenic bladder and age will be discussed.

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Children With Spinal Abnormalities Have an Increased Health Burden From Upper Tract Urolithiasis

Cited by 14 publications

References 9 publications

Retrograde intrarenal surgery by flexible ureteroscope in patients with spinal deformities

Retrograde intrarenal surgery by flexible ureteroscope in patients with spinal deformities

Complications of Surgical Management of Upper Tract Calculi in Spina Bifida Patients: Analysis of Nationwide Data

Urologic Implications and Management in Spina Bifida

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