Ureteroscopy Acceptable for Obese Stone Patients

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Ureteroscopic laser lithotripsy treatment of urinary tract stones in obese patients is associated with a success rate similar to that seen in nonobese patients, researchers at Columbia University's College of Physicians and Surgeons in New York City concluded.

Mantu Gupta, MD, and colleagues studied 107 patients who underwent flexible or semirigid ureteroscopy with holmium:yttrium-aluminum-garnet laser lithotripsy for renal and ureteral stones.

Overall, initial stone-free rates were 91%, 97%, and 94% for normal-weight (BMI 18.5-25 kg/m2), overweight (25-29.9), and obese (30 or higher) patients, respectively, according to a report in the International Brazilian Journal of Urology (2009;35:36-42). For renal and proximal ureteral stones, the stone-free rates were 93%, 94%, and 94%. For distal ureteral stones, the rates were 90%, 100%, and 100%.

Operative times were similar for the three groups: 70.37, 88.78, and 78.23 minutes, respectively. Neither stone size nor location appeared to affect outcomes.

“Our study demonstrates that ureteroscopy is an acceptable treatment modality for all ureteral calculi and may be preferable to [extracorporeal shock wave lithotripsy] for obese patients,” the authors concluded.

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