Ureteroscopy and percutaneous nephrolithototomy INT the spine cord injury patient

• Grant number: 19/13480-7
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: October 01, 2019
• End date: September 30, 2020
• Field of knowledge: Health Sciences - Medicine - Surgery
• Principal Investigator: Fábio César Miranda Torricelli
• Grantee: Lucas Albino Zanetti
• Host Institution: Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil

Abstract

Ureteroscopy and percutaneous nephrolithotomy (PCNL) are the most commom surgical techniques in the management of the upper tract urinary stones. Spine cord injury patients with bladder disfunction are a group of higher risk for kidney stone formation, and surgical treatment of kidney stones in this special population are a challenging procedure. Objective: To evaluate the safety of ureteroscopy and PCNL (complication rate) in spine cord injury patients with bladder dysfunction followed in the Division of Urology of the Hospital das Clínicas of the University of São Paulo Medical School in the period between January 2011 and December 2017. Patients and methods: A retrospective case-control study will be developed using as the following variables for marching: age, gender and body mass index (BMI). Spine cord injury patients with kidney stones will be compared to health subjects with kidney stones. Data of interest will be: age, gender, BMI, comorbidities, medications in use, previous surgeries, stone size, Guy's score, operative table position (supine versus prone), stone-free rate, bleeding volume estimated by the variation of hemoglobin and hematocrit levels, blood transfusion rate, complication rate, nephrostomy time and hospital stay time. Outcomes analysis: Univariate analysis will be performed with Student's t-tests or Mann-Whitney tests for continuous variables and Chi-square and Fisher for categorical variables. They will be compared between groups: age, gender, BMI, Guy's score, surgical table position, stone-free rate, bleeding volume, blood transfusion rate, complication rate, nephrostomy time and length of hospital stay hospital. After the univariate analysis, a multivariate analysis (regression multiple logistics) will be performed to analyze which variables influence in the complication rate.