IP06-21 THE RATE OF REPEAT SURGICAL INTERVENTION AMONG BRUSHITE STONE FORMERS AT A SINGLE INSTITUTION

Kyle Berst; Cheney Hurley; Timothy Chow; Melissa Swee; Chad Tracy; Ryan Steinberg

doi:10.1097/01.JU.0001191292.44613.d7.21

INTRODUCTION AND OBJECTIVES: Brushite (calcium monohydrogen phosphate) stone formers are notorious for requiring high rates of surgical intervention for large stone burdens and stone recurrence even after removal. The actual rate and timing of repeat surgeries has not been reported. We sought to assess the rates of repeat surgical therapy among brushite stone formers at our institution. METHODS: We conducted a retrospective, IRB-approved, single-institution review of all patients with any amount of brushite on stone analysis from January 2014 to June 2024. Patient demographics, medical histories, procedures, lab results, medications, and 24-hour urine chemistries were collected. All percutaneous nephrolithotomy (PCNL) procedures were done in prone split leg position. Ureteroscopy (URS) procedures were performed without the assistance of a suction (sheath or scope). Repeat surgery was defined as a procedure on the same side as the initial surgery >=3 months after the index surgery (or either side in the case of bilateral). Descriptive statistics were generated and Chai squared analysis was used to assess differences in rates of repeat surgery (p<0.05). RESULTS: We identified 119 brushite stone formers (40% male) with a median age of 37 years (IQR 27-53). Median follow-up was 3.9 years (IQR 0.7-8.5). 61 (51.3%) patients reported prior stone removal at another institution. 98 patients (82%) underwent initial stone surgery at our institution: 36 PCNL, 61 URS, and 1 SWL. 40 (41%) patients required a repeat surgery at a median of 22.8 months after the index procedure. After initial PCNL, 12 patients (33%) required 3 PCNL and 9 URS; after initial URS, 28 (46%) patients required 24 URS, and 4 PCNL. There was no difference in repeat surgery rates based on the index procedure (p=0.22). CONCLUSIONS: In light of aggressive initial stone removal, brushite stone formers have high rates (41%) of repeat surgery, with over half occurring within 2 years of the index case. URS was the most utilized salvage procedure. This data provides discrete data for patient counseling on the risk of recurrent surgery and underscores the importance of aggressive stone prevention.

IP06-21 THE RATE OF REPEAT SURGICAL INTERVENTION AMONG BRUSHITE STONE FORMERS AT A SINGLE INSTITUTION

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