title: The Influence of Body Mass Index on Outcomes in Ureteroscopy: Results from the Clinical Research Office of Endourological Society URS Global Study.
abstract: Although ureteroscopy (URS) has been established as a viable treatment for stones in obese patients, its safety and success has not been fully elucidated. The current study describes the worldwide prevalence of obesity in patients with urolithiasis and examines trends in URS outcomes, safety, and efficacy.
  
  
  
  This study utilized the Clinical Research Office of the Endourological Society (CROES) URS Global Study, which was a prospective, multicenter study including 11,885 patients treated with URS for urinary stones at 1 of 114 urology departments across 32 countries. The relationship between body mass index (BMI), diabetes, and creatinine, with retreatment, stone-free rates, complications, and long hospital stay, was examined with a multivariate logistic regression analyses.
  
  
  
  Of the 10,099 URS patients with BMI data, 17.4% were obese and 2.2% were super obese. Overall, 86.7% patients were stone free and 16.8% required retreatment. Higher BMI was associated with lower stone-free rates, and any deviation from normal weight was associated with higher retreatment rates. In multivariate analysis controlling for several variables including stone size, the association between BMI and lower stone-free rates with higher retreatment rates persisted. Intraoperative complications occurred in 518 (5.1%) patients, and 343 (3.4%) experienced a postoperative complication. Postoperative complications were more frequent in the underweight and super obese subjects, and there was no relationship between BMI and intraoperative complications.
  
  
  
  Although URS for stone disease was found to be an overall safe procedure for obese and super obese patients, efficacy of the procedure may be lower compared with normal-weight subjects and higher retreatment rates may be necessary.
authors: 1 Department of Urology, IU Health , Indianapolis, Indiana.
authors: Amy
authors: A
authors: Krambeck
authors: 2 Department of Urology, AMC University Hospital , Amsterdam, The Netherlands .
authors: Nienke
authors: N
authors: Wijnstok
authors: 3 Department of Urology, University Medical Center , Marburg, Germany .
authors: Peter
authors: P
authors: Olbert
authors: 4 Department of Urology, SCJU Craiova , Craiova, Romania .
authors: George
authors: G
authors: Mitroi
authors: 5 Department of Urology, Westmead Hospital and University of Sydney , Sydney, Australia .
authors: Simon
authors: S
authors: Bariol
authors: 6 Department of Urology, S. L. Raheja (Fortis associate) Hospital , Mumbai, India .
authors: Hemendra N
authors: HN
authors: Shah
authors: 7 Department of Urology, Tanta University , Tanta, Egypt .
authors: Ahmed S
authors: AS
authors: El-Abd
authors: 8 Department of Urology, Istanbul University , Cerrahpasa School of Medicine, Istanbul, Turkey .
authors: Bulent
authors: B
authors: Onal
authors: 2 Department of Urology, AMC University Hospital , Amsterdam, The Netherlands .
authors: Jean
authors: J
authors: de la Rosette
mesh_terms: D000328:Adult; D000368:Aged; D035843:Biomedical Research; D015992:Body Mass Index; D005260:Female; D006801:Humans; D007391:International Cooperation; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications; D011183:Postoperative Complications / Q000209:etiology; D015995:Prevalence; D011446:Prospective Studies; D019233:Retreatment; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000601:surgery*; D018666:Ureteroscopy / Q000379:methods*; D014545:Urinary Calculi / Q000601:surgery*; D052878:Urolithiasis / Q000601:surgery*
keywords: BMI; URS; obesity; stone disease