Category: Clinical Stones: Ureteroscopy

MP24-2 - The Role of The Chemical Analysis of The Fluid Containing Stone Dust Which Obtained Perioperatively for Predicting Stone Analysis Results in Minimal invasive Stone Surgery of The Upper Urinary System

Sun, Sep 23
10:00 AM - 12:00 PM

Introduction & Objective :

The ureterorenoscopic approach for renal and ureteral stones has been used increasingly in recent years in the treatment of stone, and stone can not be obtained for analysis in the vast majority of patients. The purpose of this study is;  investigate to fluid containing stone dust which obtained perioperativly for the role of predicting stone analysis results in patients treated with ureterorenoscopic approach.

Methods : In our clinic, 109 patients treated with ureterorenoscopic approach for stone disease were included. Perioperative fluid containing stone dust was taken with a 10 ml syringe. At the end of the operation, ureterorenoscope was removed while 3 mm fragment was taken by basket catheter. Chemical analysis of the fluid containing stone dust was performed, the stone fragment was examined at a separate center with X-Ray Diffaction (XRD) tecnique. Both centers did not know the results of the other center. The sensitivity, specificity, and accuracy of the tests were calculated. The consistency between XRD and chemical analysis results was measured with Cohen's Kappa Coefficient.

Results : Sixteen patients were excluded from the study because no stone fragment could be obtained. Struvite stones were found 100%, calcium oxalate stones and uric acid stones 99%, "calcium oxalate + uric acid" stones 98%, "calcium oxalate + calcium phosphate stones" 94% accuracy. In evaluating the density of the stones; The density of "calcium oxalate + uric acid" stones was significantly lower than the "whewellite" group. However, stone densities did not provide additional information about the stone structure, apart from the information we obtained by chemical analysis.

Conclusions : After ureterorenoscopic laser lithotripsy treatment of upper urinary system stone disease, the chemical analysis of the fluid which obtained perioperativly in patients who can not obtain a stone fragment, determines stone structure with high accuracy. The fluid containing stone dust, can be easily and perioperatively obtained from all patients so chemical analysis is superior to analyzes made with stone fragments.

Kadir Ö. Günseren

Specialist Doctor
Uludag University School of Medicine Department of Urology
bursa, Bursa, Turkey

I earned my degree in the İstanbul University of Medicine and Pharmacy. Currently, I am employed as a an urologist at Urology department of Uludag University of Medicine. İ am working for aproximately 9 years in this department (residency and the first part of my specialist career) i interest about laroscopic skills, transplantation, endourology procedures and open surgery.

İbrahim E. Arslan

Bursa, Bursa, Turkey

Hakan Kılıçcarslan

Bursa, Bursa, Turkey

Mehmet Ç.. Çicek

Bursa, Bursa, Turkey

Onur Kaygısız

Bursa, Bursa, Turkey