Introduction: Concurrent bilateral kidney stone treatment is shown to be safe (Angerri, 2019). Whether it decreases the risk of future procedures is unknown. Treating asymptomatic contralateral stones at the time of surgery remains controversial. This study examines the need for future surgical procedures in patients with asymptomatic stones in the contralateral kidney at the time of initial stone procedure.
Methods: We conducted an IRB approved retrospective chart review. Patients were enrolled if they had bilateral stones and underwent stone surgeries (SWL, URS, PCNL) between 2009 and 2018 at a referral center. Inclusion criteria included a minimum follow-up of two years and pre-operative axial imaging. Patients were divided into two groups: bilateral (simultaneous or staged [within three months]) surgery, and unilateral surgery with asymptomatic concurrent contralateral stones. For patients who had bilateral surgery, the contralateral side was defined as the side with smaller pre-operative stone size. The primary outcome was the subsequent need for surgical treatment on the contralateral kidney. Cox regression analysis was used.
Results: Of the initial 3477 patients identified 614 (322 men) met our inclusion criteria. The mean age was 59.6±14.4 years, and mean BMI was 31.5±8.7. Patients’ total follow-up time was 5.2±2.2 years (range 2-11 years). Patients who had bilateral surgery and patients who had unilateral surgery with asymptomatic concurrent contralateral stones had no difference in the need for surgical treatment for contralateral stones (27.8% vs. 29.3%, p=0.838) (Figure).
Conclusions: Our long-term analysis suggests that treating asymptomatic contralateral stones at the time of the stone surgery does not alter the risk for future operations. Source of