medigraphic.com
Organo Oficial de la Sociedad Mexicana de Urología

2024, Number 4

<< Back Next >>

Rev Mex Urol 2024; 84 (4)

Abdominal pelvic radiotherapy prolongs surgical time of retrograde endoscopic treatment of upper urinary tract stones

Canos-Nebot À, Caballero-Romeu Juan-Pablo, Caballero-Pérez P, de la Encarnación-Castellano C, Mendiola-López A, Galiano-Baena Juan-Francisco, Montoya-Lirola María-Dolores, Galán-Llopis Juan-Antonio

Language: English
References: 29
Page: 1-9
PDF size: 230.46 Kb.


ABSTRACT

Objective: the main objective is to assess whether urolithiasis diagnosed in patients with previous APRT need more endoscopic procedures to reach stone-free status and if these procedures are longer. The secondary objective is to find out if these patients have more complications resulting from endourologic procedures.
Design and methodology: we designed a case-control unicentric study including patients with upper urinary tract lithiasis treated with retrograde ureterorenoscopy (URS) between 2006 and 2022. Case patients have previous history of APRT, while controls are patients without this history. We collected epidemiological, lithiasis and treatment related information in both groups.
Results: we identified 18 upper urinary tract stones in cases that underwent endoscopic retrograde treatment. We linked these urinary stones with 18 urolithiasis diagnosed in control patients. The average age in patients and the diameter of the stones diagnosed were very similar in both groups, as well as the stones’ location. Longer surgical time was found for lithiasis treatment in case patients (129.6 versus 80.2 minutes in controls, p = 0.025). No significant differences were found regarding the rest of variables.
Limitations: this is a retrospective and observational study, and the sample size is small, so we need to expand to a multicentric study.
Originality and value: to our best knowledge this is the first study to provide data on how APRT may affect the effectiveness of endourological treatment of urolithiasis.
Conclusion: endourological procedures for treatment of upper urinary tract stones in patients with previous APRT are longer than in patients without this background.


REFERENCES

  1. Hubenak JR, Zhang Q, Branch CD, KronowitzSJ. Mechanisms of injury to normal tissue afterradiotherapy: a review. Plastic and ReconstructiveSurgery. 2014;133(1): 49e–56e. https://doi.org/10.1097/01.prs.0000440818.23647.0b.

  2. Farhood B, Khodamoradi E, Hoseini-Ghahfarokhi M, Motevaseli E, Mirtavoos-Mahyari H, Eleojo Musa A, et al. TGF-β inradiotherapy: Mechanisms of tumor resistanceand normal tissues injury. PharmacologicalResearch. 2020;155: 104745. https://doi.org/10.1016/j.phrs.2020.104745.

  3. Gianfaldoni S, Gianfaldoni R, Wollina U,Lotti J, Tchernev G, Lotti T. An Overviewon Radiotherapy: From Its History to ItsCurrent Applications in Dermatology. OpenAccess Macedonian Journal of Medical Sciences.2017;5(4): 521–525. https://doi.org/10.3889/oamjms.2017.122.

  4. Wei J, Wang B, Wang H, Meng L, Zhao Q,Li X, et al. Radiation-Induced Normal TissueDamage: Oxidative Stress and EpigeneticMechanisms. Oxidative Medicine and CellularLongevity. 2019;2019: 3010342. https://doi.org/10.1155/2019/3010342.

  5. Elliott SP, Malaeb BS. Long-term urinaryadverse effects of pelvic radiotherapy. WorldJournal of Urology. 2011;29(1): 35–41. https://doi.org/10.1007/s00345-010-0603-x.

  6. Handmer M, Martin J, Tiu A. Costing UrologicComplications Following Pelvic RadiationTherapy. Urology. 2020;140: 64–69. https://doi.org/10.1016/j.urology.2020.01.046.

  7. Sung H, Ferlay J, Siegel RL, LaversanneM, Soerjomataram I, Jemal A, et al. GlobalCancer Statistics 2020: GLOBOCAN Estimatesof Incidence and Mortality Worldwide for 36Cancers in 185 Countries. CA: a cancer journalfor clinicians. 2021;71(3): 209–249. https://doi.org/10.3322/caac.21660.

  8. Zwaans BMM, Krueger S, Bartolone SN,Chancellor MB, Marples B, Lamb LE.Modeling of chronic radiation-induced cystitisin mice. Advances in Radiation Oncology.2016;1(4): 333–343. https://doi.org/10.1016/j.adro.2016.07.004.

  9. David RV, Kahokehr AA, Lee J, WatsonDI, Leung J, O’Callaghan ME. Incidence ofgenitourinary complications following radiationtherapy for localised prostate cancer. WorldJournal of Urology. 2022;40(10): 2411–2422.https://doi.org/10.1007/s00345-022-04124-x.

  10. Bosch R, McCloskey K, Bahl A, Arlandis S,Ockrim J, Weiss J, et al. Can radiation-inducedlower urinary tract disease be amelioratedin patients treated for pelvic organ cancer:ICI-RS 2019? Neurourology and Urodynamics.2020;39(Suppl 3): S148–S155. https://doi.org/10.1002/nau.24380.

  11. Sindelar WF, Kinsella TJ. Normal tissuetolerance to intraoperative radiotherapy.Surgical Oncology Clinics of North America.2003;12(4): 925–942. https://doi.org/10.1016/s1055-3207(03)00087-5.

  12. Beller HL, Rapp DE, Zillioux J, Abdalla B, DuskaLR, Showalter TN, et al. Urologic ComplicationsRequiring Intervention Following High-dosePelvic Radiation for Cervical Cancer. Urology.2021;151: 107–112. https://doi.org/10.1016/j.urology.2020.09.011.

  13. Goodman M, Dalton JR. Ureteral stricturesfollowing radiotherapy: incidence, etiology andtreatment guidelines. The Journal of Urology.1982;128(1): 21–24. https://doi.org/10.1016/s0022-5347(17)52732-9.

  14. Simeone C, Tanello M, Rosini R, Botturi A,Tralce L, Sironi D, et al. [“Post-actinic pelvicdisease” and the ureter: the post-actinic ureter].Archivio Italiano Di Urologia, Andrologia: OrganoUfficiale [di] Societa Italiana Di EcografiaUrologica E Nefrologica. 2002;74(1): 12–15.

  15. Chrouser KL, Leibovich BC, Sweat SD, LarsonDW, Davis BJ, Tran NV, et al. Urinary fistulasfollowing external radiation or permanentbrachytherapy for the treatment of prostatecancer. The Journal of Urology. 2005;173(6):1953–1957. https://doi.org/10.1097/01.ju.0000158041.77063.ff.

  16. Mitterberger M, Frauscher F, Steppan I, PeschelR, Pinggera GM. Ureteroiliac fistula: a casereport review of the literature. Cases Journal.2009;2: 6266. https://doi.org/10.4076/1757-1626-2-6266.

  17. Batter SJ, McGovern FJ, Cambria RP.Ureteroarterial fistula: case report andreview of the literature. Urology. 1996;48(3):481–489. https://doi.org/10.1016/S0090-4295(96)00202-6.

  18. Tuite DJ, Ryan JM, Johnston C, Brophy DP,McEniff N. Case report: ureteroiliac fistula:a late sequela of radiotherapy and long-termureteric stent placement. Clinical Radiology.2006;61(6): 531–534. https://doi.org/10.1016/j.crad.2006.02.001.

  19. Turo R, Hadome E, Somov P, Hamid B, GulurDM, Pettersson BA, et al. Uretero-Arterial Fistula- Not So Rare? Current Urology. 2018;12(1): 54–56. https://doi.org/10.1159/000489419.

  20. Toolin E, Pollack HM, McLean GK, BannerMP, Wein AJ. Ureteroarterial fistula: a casereport. The Journal of Urology. 1984;132(3):553–554. https://doi.org/10.1016/s0022-5347(17)49734-5.

  21. Kelleher JP, Snell ME. Pelvic irradiation, theureter and extracorporeal shockwave lithotripsy.British Journal of Urology. 1990;66(4): 437.https://doi.org/10.1111/j.1464-410x.1990.tb14977.x.

  22. Ibrahim AK. Reporting ureteroscopycomplications using the modified clavienclassification system. Urology Annals. 2015;7(1):53–57. https://doi.org/10.4103/0974-7796.148611.

  23. Perez Castro E, Osther PJS, Jinga V, Razvi H,Stravodimos KG, Parikh K, et al. Differencesin ureteroscopic stone treatment and outcomesfor distal, mid-, proximal, or multiple ureterallocations: the Clinical Research Office of theEndourological Society ureteroscopy globalstudy. European Urology. 2014;66(1): 102–109.https://doi.org/10.1016/j.eururo.2014.01.011.

  24. Caballero Romeu JP, Galán Llopis JA. MicroURS¿una técnica para quedarse? Archivos Españolesde Urología 2017; 134–140.

  25. Caballero-Romeu JP, Galán-Llopis JA, SoriaF, Morcillo-Martín E, Caballero-Pérez P,Garcia A, et al. Micro-ureteroscopy vs.ureteroscopy: effects of miniaturization onrenal vascularization and intrapelvic pressure.World Journal of Urology. 2018;36(5): 811–817.https://doi.org/10.1007/s00345-018-2205-y.

  26. Shahrour W, Joshi P, Hunter CB, Batra VS,Elmansy H, Surana S, et al. The Benefits of Usinga Small Caliber Ureteroscope in Evaluation andManagement of Urethral Stricture. Advancesin Urology. 2018;2018: 9137892. https://doi.org/10.1155/2018/9137892.

  27. Zeng GH, Li X, Wu KJ, Chen WZ. [Endoscopicmanagement of bilateral ureteral obstructionafter radiotherapy]. Ai Zheng = Aizheng =Chinese Journal of Cancer. 2004;23(1): 108–109.

  28. Schoenthaler M, Buchholz N, Farin E, Ather H,Bach C, Bach T, et al. The Post-UreteroscopicLesion Scale (PULS): a multicenter video-basedevaluation of inter-rater reliability. World Journalof Urology. 2014;32(4): 1033–1040. https://doi.org/10.1007/s00345-013-1185-1.

  29. Darwish AE, Gadelmoula MM, AbdelkawiIF, Abdellatif AM, Abdel-Moneim AM,Hammouda HM. Ureteral stricture afterureteroscopy for stones: A prospective study forthe incidence and risk factors. Urology Annals.2019;11(3): 276–281. https://doi.org/10.4103/UA.UA_110_18.




2020     |     www.medigraphic.com