WCE 2017: Imaging Patterns After Percutaneous Nephrolithotomy

Vancouver, Canada (UroToday.com) Ahn et al. present a retrospective study of 6,495 patients identified through the use of Marketscan®, a national database that captures patient-specific longitudinal data through claims from hospitals, outpatient centers, surgeons, physicians, and independent laboratories. Patients aged 17 to 64 years who underwent percutaneous nephrolithotomy (PCNL) from 2007 to 2014 were included in the final analytical cohort. CPT and ICD-9 codes were used to identify the modality of postoperative imaging. 

Seventy-one percent of patients received at least one modality of imaging by three months in their postoperative course, with the most common modality being a KUB, followed closely by CT. On further analysis, 67% of patients did not receive any type of anatomic imaging, such as CT, intravenous pyelogram, or renal ultrasound, by three months post-procedure.

These authors deserve applause for highlighting that nearly 30% of patients, who have undergone PCNL, do not receive any form of imaging by three months post-procedure. However, data on the optimal timing to obtain imaging studies post-procedure is limited. By twelve months, the percent of patients who did not receive any imaging studies drops to 15%. Interestingly, the use of renal ultrasound increased by 13% over this seven-year study period, possibly reflecting the effects of the AUA white paper published in 2012 on the management of ureteral stones.

However, another important question is whether or not patients were symptomatic at the time of post-procedure imaging, as this would likely affect clinical decision-making on the type of imaging to order.

Presented by: Justin S. Ahn, MD

Authors: Justin S. Ahn, Sarah Holt, Philip May, Mathew D. Sorensen, and Jonathan D. Harper, MD 
Affiliation: University of Washington School of Medicine, Seattle, WA, USA

Written by: Michael Owyong (@ohyoungmike), LIFT Fellow, Department of Urology, UC Irvine Medical Center, Orange, CA, USA at 35th World Congress of Endourology– September 12-16, 2017, Vancouver, Canada.