Valoración del impacto de la tasa libre de litiasis en los resultados de la evaluación metabólica / Is stone free status really necessary for metabolic evaluation following stone removal procedures?

Objetivo Evaluar si la tasa libre de litiasis afecta a los resultados del estudio metabólico en pacientes con alto riesgo de litiasis recidivante tras tratamiento completo mediante ureteroscopia. Pacientes y métodos Un total de 78 pacientes sometidos a cirugía retrógrada intrarrenal (CRIR) para el tratamiento de litiasis fueron incluidos en este estudio. Cuatro semanas después del tratamiento, los casos se dividieron en dos grupos en base a los resultados de la tomografía computarizada sin contraste (TCSC). Los casos del grupo 1 (n=54) presentaban una tasa libre de litiasis del 100% y los del grupo 2 (n=24) presentaban litiasis residuales en el riñón. Cuatro semanas después de la ureteroscopia flexible (URF) se realizó un análisis completo de orina de 24h a todos los pacientes de ambos grupos, para detectar los factores de riesgo implicados en la litogénesis. Los resultados del estudio metabólico (orina de 24h y suero) se compararon entre los dos grupos. Resultados La evaluación preoperatoria en orina y suero de los factores de riesgo asociados a la formación de cálculos no reveló diferencias estadísticas entre los dos grupos. El análisis comparativo de los factores de riesgo implicados en la formación de la litiasis mediante pruebas de orina de 24h tampoco reveló diferencias estadísticamente significativas entre los resultados preoperatorios y postoperatorios en los casos del grupo 2 con cálculos residuales. Tampoco se observaron diferencias significativas entre las medias de las variables séricas preoperatorias y postoperatorias de ambos grupos. Conclusiones Según nuestros resultados, y dada la similitud de los hallazgos obtenidos en los estudios metabólicos de los casos con y sin litiasis residual, la tasa libre de litiasis puede no constituir un factor imprescindible para la realización del estudio metabólico detallado (suero y orina de 24h) tras las intervenciones endourológicas para la extracción de los cálculos renales. (AU)

Objective To evaluate the impact of stone free status on the outcomes of metabolic evaluation in recurrent stone formers after ureteroscopic stone removal. Patients and methods A total of 78 patients undergoing retrograde intrarenal surgery (RIRS) for renal stones were included and cases were divided into two groups after 4 weeks based on the NCCT findings. While cases in the Group 1 (n=54) was completely stone free, cases in Group 2 (n=24) had residual fragments in the kidney. A full 24-hour urine analysis for relevant stone forming risk factors has been performed after 4 weeks following the fURS procedures in all patients of both groups. Outcomes of metabolic evaluation (24-hour urine and serum) have been comparatively evaluated in both groups. Results Evaluation of the preoperative serum and urine stone forming risk factors revelaed no statistical difference in both groups. Comparative evaluation of the 24-hour urinary stone forming risk factors also revealed no statistically significant difference between preoperative and postoperative findings in cases of Group 2 with residual stones. Last but not least, no significant difference was observed between the mean preoperative and postoperative serum variables between two groups. Conclusions Our results show that in the light of the similar metabolic evaluation outcomes obtained in cases with and without residual fragments, ‘stone free status’ may not be an essential factor to perform a detailed metabolic evaluation (24-hour urine analysis and serum parameters) after endourological stone removal procedures. (AU)

Evaluation of sexual function in patients submitted to ureteroscopic procedures.

OBJECTIVE: We aimed to evaluate the possible effects of ureteroscopic procedures on the sexual function of both genders. MATERIALS AND METHODS: A total of 102 sexually active cases (60 male, 42 female) undergoing ureteroscopic procedures were included in this study. Sexual function has been evaluated in detail by using International Index of Erectile Function (IIEF) in male and Female Sexual Function Index (FSFI) forms in female cases both before and 1-month after the procedures. Pre-and postoperative data were evaluated in a comparative manner. RESULTS: The pre-and postoperative mean IIEF scores were 57.86 ± 2.26 and 54.57 ± 2.48 (p = 0.19) in males and the mean FSFI scores were 13.58 ± 1.46 and 14.46 ± 1.52 (p = 0.41), respectively in females. Evaluation of these values showed that regarding the effects of this procedure on male cases although the total scores for sexual function were not influenced it was observed a significant reduction in the intercourse satisfaction subdomain (IIEF-IS) in males (p < 0.05). In female cases however, unlike the male cases no statistically significant alterations with respect to these scores were noted (p = 0.418). CONCLUSION: Ureteroscopic interventions could have some adverse effects on the sexual function particularly in male cases. However, it is clear that further prospective studies in both genders with large population of cases are certainly needed in order to outline this unresolved but important subject.

Evaluation of sexual function in patients submitted to ureteroscopic procedures

ABSTRACTObjective:We aimed to evaluate the possible effects of ureteroscopic procedures on the sexual function of both genders.Materials and Methods:A total of 102 sexually active cases (60 male, 42 female) undergoing ureteroscopic procedures were included in this study. Sexual function has been evaluated in detail by using International Index of Erectile Function (IIEF) in male and Female Sexual Function Index (FSFI) forms in female cases both before and 1-month after the procedures. Pre-and postoperative data were evaluated in a comparative manner.Results:The pre-and postoperative mean IIEF scores were 57.86±2.26 and 54.57±2.48 (p=0.19) in males and the mean FSFI scores were 13.58±1.46 and 14.46±1.52 (p=0.41), respectively in females. Evaluation of these values showed that regarding the effects of this procedure on male cases although the total scores for sexual function were not influenced it was observed a significant reduction in the intercourse satisfaction sub-domain (IIEF-IS) in males (p<0.05). In female cases however, unlike the male cases no statistically significant alterations with respect to these scores were noted (p=0.418).Conclusion:Ureteroscopic interventions could have some adverse effects on the sexual function particularly in male cases. However, it is clear that further prospective studies in both genders with large population of cases are certainly needed in order to outline this unresolved but important subject.