Delaying kidney stone surgery is associated with an increased likelihood of requiring complex stone procedures, according to study findings presented at the American Urological Association’s 2023 annual meeting in Chicago, Illinois.

David Bayne, MD, MPH, of the University of California, San Francisco, and colleagues retrospectively studied 45,764 patients who had emergency department visits for kidney stones followed by a urologic stone procedure. Compared with patients who underwent surgery within 1 month of emergency department presentation, those waiting 6 months or more, 1 year or more, and 3 years or more had significant 20%, 29%, and 43% increased odds of undergoing complex surgery, respectively. The investigators defined complex surgery as initial percutaneous nephrolithotomy and/or undergoing more than 1 procedure within 365 days of initial intervention.

In addition, the investigators found that patients on Medicaid or Medicare had significant 57% and 28% increased odds of undergoing complex stone surgery compared with patients with private insurance. Living more than 10 miles from a surgical facility was associated with 11% increased odds of undergoing complex stone surgery. Patients with more comorbidities also were more likely to undergo complex stone surgery.

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The investigators conducted their study using information from the California Department of Health Care Access and Information dataset.


Maru J, Srirangapatanam S, Hicks C, Armas-Phan M, et al. Effects of delayed surgical intervention following ED presentation on stone surgery complexity. Presented at: AUA 2023, Chicago, Illinois, April 28-May 1. Abstract MP16-04.