title: Surgical management of urolithiasis in spinal cord injury patients.
abstract: Urolithiasis is a common condition in patients with spinal cord injury (SCI). Surgical management of stones in this population is more challenging and associated with lower clearance rates than the general population. The rate of complications - specifically infectious complications - is also high due to the chronic bacterial colonization. Shock wave lithotripsy (SWL) has a low clearance rate of 44-73 %. Percutaneous nephrolithotripsy is indicated for larger nephrolithiasis, but multiple procedures may be required to clear the stones. Ureteroscopy has been associated with low success rates because of difficulty in obtaining ureteral access. Historically, bladder stones were managed with open surgery or SWL. Recently, good results have been reported with the combination of endoscopic and laparoscopic techniques. Surgical management of urolithiasis in patients with SCI should be performed in high-volume centers in light of the technical challenges and higher rate of perioperative complications.
authors.affiliation: University of Oklahoma Health Sciences Center, 920 Stanton L. Young Blvd, WP 3150, Oklahoma City, OK, 73104, USA, philippe-nabbout@ouhsc.edu.
authors.forename: Philippe
authors.initials: P
authors.lastname: Nabbout
authors.forename: Gennady
authors.initials: G
authors.lastname: Slobodov
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Culkin
mesh_terms: D006801:Humans; D008096:Lithotripsy / Q000379:methods; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D013119:Spinal Cord Injuries / Q000150:complications*; D018666:Ureteroscopy / Q000379:methods*; D001744:Urinary Bladder Calculi / Q000601:surgery; D014552:Urinary Tract Infections / Q000150:complications*; D052878:Urolithiasis / Q000150:complications / Q000601:surgery*
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